RACE  DECADENCE 


WHUAM  S.  SADLER,  M,  D. 


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RACE  DECADENCE 


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RACE  DECADENCE 

An  Examination  of  the  Causes  of  Racial 
Degeneracy  in  the  United  States 


BY 
WILLIAM  S.  SADLER,  M.D.,  F.A.C.S. 

PROFESSOR  AT  THE  POST  GRADUATE  MEDICAL  SCHOOL  OF  CHICAGO;    FELLOW  OF 
THE    AMERICAN    COLLEGE    OF   SURGEONS;    SENIOR    ATTENDING    SURGEON 
TO    COLUMBUS    HOSPITAL;    DIRECTOR  THE    CHICAGO    INSTITUTE   OF 
RESEARCH     AND     DIAGNOSIS;     FELLOW    OF     THE     AMERICAN 
MEDICAL     ASSOCIATION;    MEMBER     OF    THE     CHICAGO 
MEDICAL   SOCIETY:    THE    ILLINOIS   STATE  MEDI- 
CAL   SOCIETY;     THE     AMERICAN      PUBLIC 
HEALTH      ASSOCIATION.      ETC. 


ILL  USTRA  TED 


CHICAGO 
A.  C  McCLURG  &  CO. 

1922    ABR,  L  WOLBARST,  M,  D, 
114  EAST  61st  STREET 
NEW  YORK 


Copyright 

A.  C.  McClurg  &  Co. 
1922 


Published  January,  1922 


Copyrighted  in  Great  Britain 


Printed  in  the  United  States  of  America 


M.    A.    DONOHUE    &    CO..   PRINTERS    AND    BINDERS,   CHICAGO 


P  r  e  f  a  c  e 


IMPORTANT  as  is  the  health  of  the  individual  —  personal 
hygiene,  still  more  important  is  the  health  and  vigor  of  the 
nation  —  race  hygiene.  Human  society  has  certainly  not 
reached  a  very  high  plane  of  unselfishness  and  altruism  when 
its  scientific  energies  are  almost  wholly  consumed  with  the 
betterment  of  the  individual;  and  yet,  in  the  recent  past,  the 
great  efforts  of  preventive  medicine  in  the  development  of 
modern  hygiene  have  been  devoted  almost  exclusively  to  the 
improvement  of  the  individual.  Of  course  the  public,  as  a 
whole,  benefits  by  all  these  efforts  looking  toward  the  pre- 
vention of  disease  and  the  improvement  of  human  health 
and  efficiency ;  but  has  not  the  time  come  when  society 
should  look  out  upon  a  horizon  broad  enough  to  take  into 
consideration  the  unborn  generations  in  all  our  plans  look- 
ing toward  human  betterment? 

It  must  not  be  inferred  from  the  title  of  this  work  that 
the  author  is  a  pessimist.  This  book  deals  with  the  evidences 
of  race  decadence,  but  is  to  be  followed  by  volumes  dealing 
with  race  betterment,  and  presenting  the  encouraging  and 
more  optimistic  side  of  this  momentous  question.  The  author 
believes  in  a  great  destiny  for  the  human  race,  and  is  in  no 
sense  a  pessimist. 

It  is  our  purpose  carefully  to  examine  the  causes  and 
influences  which  are  at  work  among  civilized  peoples,  which 
contribute  more  or  less  to  a  possible  deterioration  of  the 
"  stock  "  of  the  white  races ;  and  also  to  present  an  outline  of 
those  plans  and  propaganda  which,  in  the  opinion  of  the 


VI  PREFACE 

author,  may  tend  to  combat  these  deteriorating  influences, 
and  otherwise  counter-work  those  conditions  which  we  be- 
lieve to  interfere  somewhat  with  normal  human  progress; 
and  in  subsequent  treatises  to  present  a  more  definite  pro- 
gram which  we  believe  will  contribute  immensely  to  the 
immediate  improvement  of  the  mental  and  moral  fiber  of 
the  white  races  in  general,  and  the  American  people  in 
particular. 

It  is  the  plan  of  this  book  to  discuss  this  question  of  race 
decadence  under  two  heads : 

1.  Physical  Decadence  —  that  is,  the  question  of  physical 
hygiene  as  concerned  in  race  efficiency  and  in  particular 
with  reference  to  the  alarming  increase  in  recent  years  of 
cancer,  venereal   diseases,   and  the   so-called    "  old-age " 
disorders. 

2.  Mental  Degeneracy  —  the  apparent  increase  in  mental 
and   nervous   diseases  —  the  vast   prevalence   of    feeble- 
mindedness, epilepsy,  insanity,  etc.,  as  they  threaten  the 
integrity  and  stability  of  the  American  people. 

The  author  is  well  aware  of  the  fact  that  there  are 
many  troubles  in  the  body  politic ;  that  there  are  many  prob- 
lems before  the  American  people  for  solution,  which  are 
not  discussed  in  this  thesis.  We  are  quite  alive  to  our  politi- 
cal, social,  and  industrial  difficulties,  and  we  are  not  blind  to 
the  fact  that  we  have  a  peculiar  race-and-color  problem  of  our 
own,  one  which  cannot  be  touched  upon  in  a  book  with  the 
limitations  of  this  work.  Nevertheless,  notwithstanding  all 
these  many  questions  now  pressing  themselves  upon  the 
public  for  solution,  we  believe  that  in  the  immediate  future, 
even  if  we  succeed  in  solving  in  the  most  satisfactory  manner 
our  present  social  and  labor  difficulties  —  even  if  the  country 
should  become  well-nigh  Utopian  as  regards  present  troubles 
which  are  pressing  for  solution — still  there  would  confront 


PREFACE  vii 

•us  the  great  problems  which  form  the  topics  for  discussion 
in  the  two  sections  of  this  book.  These  difficulties  which 
threaten  the  integrity  of  the  race,  and  jeopardize  the  conti- 
nuity of  the  nation,  would  still  present  themselves  for  adjust- 
ment and  solution. 

In  Part  I  we  undertake  to  show  the  great  waste  from  un- 
necessary and  preventable  disease  on  the  one  hand,  and  the 
tremendous  national  loss  by  premature  deaths  on  the  other ; 
to  point  out  specifically  those  diseases  and  causes  which  un- 
dermine the  health  of  the  people  and  carry  away  so  many  of 
our  fellow-citizens  prematurely;  to  show  that  many  of  these 
maladies  have  a  hereditary  basis ;  and  at  the  same  time  to  pro- 
pose those  practical  suggestions  which  the  modern  methods 
of  preventive  medicine  have  to  offer  as  a  remedy  for  this 
i^nnecessary  and  appalling  wastage. 

In  Part  u  we  undertake  to  present  to  the  reader  a  picture 
of  the  intellectual  catastrophe  which  awaits  the  American 
people  if  they  go  on  for  an  indefinite  period  unmindful  of, 
and  indifferent  to,  the  menace  of  feeble-mindedness  and  other 
forms  of  mental  deterioration  which,  in  common  with  epilepsy 
and  insanity,  loom  so  large  upon  the  social  horizon  of  the 
present  day ;  and  in  connection  with  the  presentation  of  these 
statistics  and  a  statement  of  these  known  facts,  to  offer  prac- 
tical suggestions  looking  toward  a  humanitarian  control  of 
these  race-destroying  strains  of  the  human  family  which 
have  gained  such  a  foothold  among  the  people  of  this  fair 
land. 

While  the  author  is  in  no  wise  immediately  alarmed  over 
the  threat  of  the  conditions  which  confront  us,  and  which  he 
has  endeavored  to  portray  in  this  book;  while  he  is  not  an 
alarmist,  and  has  great  faith  in  the  future  greatness,  attain- 
ment, and  development  of  the  American  people ;  at  the  same 
time  he  does  most  sincerely  believe  that  on  the  American 
continent  and  in  the  present  American  society  and  govern- 


PREFACE 

ment,  the  civilization  of  the  white  race  is  destined  to  make 
its  last  stand. 

And,  therefore,  while  not  considering  these  matters  in  too 
grave  a  light,  but  at  the  same  time  taking  the  mission  which 
he  has  endeavored  to  fulfil  in  this  and  subsequent  volumes 
quite  seriously ;  it  will  be  apparent  that  if  but  a  little  bit  has 
been  contributed  to  the  clarification  of  these  basic  problems 
which  confront  the  nation;  if  but  a  mite  has  been  added  to 
aid  in  solving  the  menacing  difficulties  discussed  in  this  work ; 
if  but  even  a  trifle  has  been  added  to  the  final  turning  of 
the  tide  of  evil  influences  which  jeopardize  the  white  races  in 
general  and  the  American  stock  in  particular,  then  will  we 
have  been  repaid  manifold  for  the  research  and  other  efforts 
entailed  by  the  writing  of  this  book. 

WILLIAM  S.  SADLER. 
533  DIVERSEY  PARKWAY,  CHICAGO, 
October  i, 


CONTENTS 


PART  I 

PHYSICAL  DECADENCE,  OR,  THE  INCREASE  OF  CERTAIN 

BODILY  DISEASES 
CHAPTER  PAGE 

I     What  Ails  Uncle  Sam? I 

II     Our  First  National  Health  Inventory 12 

III  Postponing  Your  Funeral 31 

IV  Sickness  in  the  United  States 49 

.     V     Triumphs  and  Failures  of  Preventive  Medicine     71 

VI  The  Cancer  Problem 92 

VII  The  White  Plague 102 

VIII  The  Great   Black   Plague no 

IX  Increase  in  "  Old- Age  "  Diseases 132 

X     Heart     Failure,     Hardened     Arteries,      and 

Bright's  Disease   142 

XI     Causes  of  "  Old- Age  "  Disorders 154 

XII     Treatment  of  "Old- Age"  Disorders 165 

XIII  The  Laws  of  Health  in  a  Nutshell 181 

PART  II 

MENTAL  DEGENERACY,  OR,  THE  INCREASE  IN  MENTAL  AND 
NERVOUS  DISORDERS 

XIV  Are  We  Becoming  a  Neurotic  Race? 195 

XV     Is  Insanity  Increasing? 212 

XVI     Feeble-Mindedness    233 

XVII     The  Moron  Problem 253 

ix 


x  CONTENTS 

CHAPTER  PAGE 

XVIII     Epilepsy  and  Sex  Perversion 263 

XIX     The  Backward  Child 272 

XX     Feeble-Mindedness  in  Relation  to  Crime 280 

XXI     Feeble-Mindedness   in   Relation  to   Vice   and 

Poverty 299 

XXII     Borderland  Defectives   316 

XXIII  The  "Aristocracy  of  the  Unfit " 329 

XXIV  Desirability  of  Restricting  the  Unfit 344 

XXV    Looking  Facts  in  the  Face 368 

Appendix  A  —  Statistical  Tables 377 

Appendix  B  —  Economic  Losses   from  Sick- 
ness      392 

Appendix  C  —  Diet  Lists 404 


ILLUSTRATIONS 


FIGURE  PAGE 

1  Examining  drafted  men 14 

2  Results  of  examining  supposedly  well  people   .    .  22 

3  Are   the  giants   disappearing?      Captain    George 

Auger,  8  feet  4  inches  tall,  and  Lady  Little,  but 

30  inches   high 24 

4  Graphic  showing  principal  causes  of  death  in  the 

United  States 37 

^     Graphic  illustrating  the  increased  and  the  decreased 

death-rates  of  certain  common  diseases   ....  82 

6  Showing  deaths  from  different  forms  of  cancer  .  94 

7  Sleeping-porches  are  great  promoters  and  preserv- 

ers  of    health 106 

8  Organisms  causing  the  Great  Black  Plague   ...  112 

9  Graphic  showing  increase  in  death-rates  from  the 

four    leading    diseases,    covering   a    period    of 

eighteen  years 134 

10  Forms  of  cell  degeneration  in  the  human  body.    .  137 

11  Exercises  adapted  to  moderately  high  blood-pres- 

sure     166 

12  Graphic    showing    increase    in    insanity    in    the 

United    States 218 

13  Typical  institution  for  the  feeble-minded   ....  234 

14  Scheme  of  classification  of  mental  abnormalities   .  236 

1 5  An  epileptic  colony 264 

1 6  Apparatus  used  in  testing  abnormal  children  .    .  274 

17  A  typical  feeble-minded  family 306 

18  Ellis  Island  —  the  gateway  of  the  immigrant  .    .  358 


PART  I 

Physical  De-cadence 

or 
The  Increase  of  Certain  Bodily  Diseases 


Race    Decadence 


CHAPTER  I 
WHAT  AILS  UNCLE  SAM? 

THE  author  is  not  oblivious  to  the  many  pressing  prob- 
lems  and    difficulties    which   confront   the    American 
people  at  the  present  time,  and  which   clamor   so   loudly 
for  immediate  attention. 

tThe  answer  to  the  question,  What  ails  Uncle  Sam?  calls 
for  a  sweeping  glance  around  the  social  horizon;  for  an 
intelligent  survey  of  our  industrial  front;  for  a  careful 
consideration  of  our  political  tangles  and  our  international 
relations.  But  with  all  our  study,  and  after  all  our  ef- 
forts to  solve  these  things,  the  fundamental  national  ills 
which  are  discussed  in  this  work  still  remain;  and  so, 
while  we  go  about  the  task  of  adjusting  and  settling  these 
various  questions  of  vital  concern,  we  believe  we  will  be 
directly  aided  in  forming  a  proper  perspective  if,  at  the 
same  time,  we  will  take  into  consideration  some  of  those 
fundamental  and  basic  weaknesses  which  are  inherent  in  our 
present-day  social  organization  and  racial  composition.  In 
other  words,  if  we  can  get  a  clearer  view  of  this  background 
of  permanent  problems  which  challenge  our  united  efforts, 
and  which  must  some  day  demand  our  combined  energy 
for  solution  —  with  this  enlightening  background  of  facts 
and  factors  —  will  we  not  be  all  the  better  prepared  and 
equipped  to  undertake  the  successful  adjustment  of  the 


2  RACE  DECADENCE 

numerous,  but  transient  social,  political,  and  economic 
questions,  which  so  insistently  crowd  to  the  front  of  the 
stage  and  which  so  loudly  clamor  for  immediate  attention? 

OUR   ECONOMIC    PROBLEMS 

The  perplexities  growing  out  of  the  economic  disturbances 
of  war,  and  the  subsequent  era  of  the  High  Cost  of  Living, 
with  all  their  associated  problems ;  the  difficulties  produced  by 
the  rapid  depletion  of  the  western  farm  lands  which  were 
fresh  and  new  but  a  short  time  ago,  and  which  have  been 
worked  year  after  year  without  much  thought  of  fertilization 
or  scientific  crop  rotation;  the  continued  drift  of  the  popula- 
tion from  the  country  to  the  city,  with  its  resultant  depletion 
of  the  agricultural  classes ;  the  problem  of  eliminating  the  un- 
necessary middleman  and  other  lost  motion  between  the  pro- 
ducer and  the  consumer;  the  function  of  the  parcel  post  and 
the  automobile  in  our  future  industrial  organization;  yes, 
these  and  many  other  similar  questions  are  up  for  considera- 
tion in  this  trying  era  of  reconstruction,  and  we  will,  in  due 
time,  solve  them  all.  Whatever  the  difficulties  and  complica- 
tions, we  will  find  an  ultimate  way  out.  But  we  believe  that 
a  clear  view  of  the  underlying  biologic  facts  will  greatly  help 
us  to  a  more  comprehensive  understanding  of  these  asso- 
ciated surface  problems  of  an  economic  and  political  nature 
—  and  indirectly  contribute  something  to  hastening  their 
satisfactory  settlement. 

THE  INDUSTRIAL  SITUATION 

We  have  extraordinary  industrial  difficulties  to  overcome 
in  the  immediate  future,  not  merely  questions  dealing  with 
the  supply  of  labor  and  underproduction;  not  merely  the 
stress  and  strain  to  which  our  industries  are  now  subjected 
as  a  result  of  the  vast  destruction  associated  with  the  World 
War  and  the  subsequent  slowing  down  of  production 


WHAT  AILS  UNCLE  SAM?  3 

throughout  the  world;  but  we  also  have  our  own  long-time 
chronic  and  now  acute  problems  of  labor  and  capital.  The 
questions  of  equity  involved  in  the  administration  of  vast 
industries;  the  future  course  and  evolution  of  the  gigantic 
capitalistic  interests  on  the  one  hand,  and  the  labor  unions 
and  organized  workers  on  the  other,  interest  and  concern 
every  American  citizen.  But,  as  we  shall  see,  the  final  solu- 
tion of  many  of  these  industrial  difficulties  is  bound  up  with 
the  proper  understanding  of  some  of  these  vital  and  funda- 
mental biologic  themes  which  constitute  the  basic  discussions 
of  this  volume. 

If  we  can  do  something  immediately  and  directly  to  ad- 
vance the  health  and  vigor  of  the  American  people;  if  we 
can  set  in  motion  influences  which  will  certainly  improve  both 
the  quantity  and  quality  of  the  next  generation;  if  we  can 
do  sdmething  to  lessen  the  flood  of  inferior  immigrant  stock, 
which  deteriorates  our  national  worth  —  if  we  can  do  only 
a  little  to  realize  some  of  the  hopes  of  better  things,  outlined 
in  this  work  —  then  will  we  also  have  done  much  to  improve 
our  industrial  situation  and  to  better  our  whole  social  and 
economic  status.  Our  social  questions  are  not  going  to  be 
finally  settled  by  a  generation  that  refuses  to  study  and  know 
the  laws  of  human  heredity,  and  which  closes  its  eyes  to  the 
scientific  principles  of  race  betterment  and  national  uplift. 

OUR  POLITICAL  SITUATION 

There  are  many  problems  of  a  political  nature  which  the 
American  people  must  settle  one  way  or  another  in  the  next 
few  years;  not  merely  the  question  of  the  League  of  Nations 
and  our  future  position  as  regards  our  foreign  relations  and 
international  obligations;  not  only  the  question  of  whether 
or  not  we  shall  have  universal  military  training ;  not  merely 
the  questions  of  improved  municipal  administration  and  ad- 
vanced state  government;  but  also  those  propositions  which 


4  RACE  DECADENCE 

have  to  do  with  government  ownership  and  government  regu- 
lation. Are  we  going  to  socialize  great  industries  like  the 
railroads,  or  are  we  going  to  regulate  them  in  a  business-like 
manner?  Are  we  going  to  continue  a  democracy  where  the 
majority  rule,  with  universal  suffrage,  or  are  we  going  to 
experiment  with  new  and  untried  theories  of  political  govern- 
ment which  some  alien  agitator  may  seek  to  force  upon  the 
country  ?  All  of  these  and  many  other  related  political  prob- 
lems cry  out  for  solution  —  and  they  must  have  attention; 
but,  if  the  reader  will  carefully  consider  the  studies  of  this 
work,  particularly  those  chapters  in  Part  n,  much  will  be 
found,  we  believe,  which  will  help  the  average  American  citi- 
zen to  look  at  these  things  in  a  broader  and  more  far-reaching 
light  than  that  in  which  we  have  hitherto  considered  them; 
and,  in  other  ways  to  look  at  our  past,  present,  and  future 
from  a  racial  standpoint  —  from  such  a  standpoint  as  prom- 
ises to  help  us  in  finding  a  probable  and  lasting  remedy  for 
some  of  our  many  present  political  difficulties.  Today  we 
need  politics  vitalized  by  principles,  and  politicians  perme- 
ated with  fundamental  facts  and  energized  by  the  tested 
truths  of  biologic  science. 

SOME  OF  OUR  SOCIAL  QUESTIONS 

The  dilemma  which  confronts  us  as  a  nation  today  has 
not  merely  to  do  with  the  difficulties  of  making  this  country 
safe  for  democracy,  but  also  includes  those  many  problems 
which  we  commonly  group  under  the  head  of  "  social  develop- 
ment "  —  welfare  work.  The  educational  situation,  the  fu- 
ture of  the  public-school  system,  the  education  of  immigrants 
whom  we  allow  to  come  within  our  gates ;  the  Americaniza- 
tion of  our  foreign  population  —  present  and  future;  the 
question  as  to  whether  or  not  the  mental  caliber  of  our  public- 
school  teachers  is  to  be  allowed  to  decrease  from  decade  to 
decade  —  because  we  are  too  shortsighted  to  pay  them  a  liv- 


WHAT  AILS  UNCLE  SAM?  5 

ing  wage.  These  and  many  other  questions,  not  to  mention 
prohibition  and  the  stamping  out  of  drug  habits,  all  call  for 
a  clear  understanding  of  applied  eugenics.  So,  when  these 
social  problems  knock  at  our  door  for  consideration  —  some 
of  them  clamor  for  immediate  attention  —  we  believe  that 
the  discussions  of  Part  n  of  this  book  (those  chapters  dealing 
with  ultimate  race  betterment,  and  which  point  out  the  neces- 
sity for  the  American  people  to  do  something  about  feeble- 
mindedness and  insanity)  will  help  the  reader  to  form  a  more 
intelligent  opinion  respecting  these  numerous  problems,  and 
thus  be  in  a  position  to  contribute  something  toward  a  more 
complete  and  satisfactory  settlement  of  many  of  these  harass- 
ing social  difficulties. 

A  better  knowledge  of  the  accepted  laws  of  heredity,  to- 
gafher  with  a  more  complete  understanding  of  the  compara- 
tive value  and  influence  of  race  and  education  —  of  nature 
and  nurture  —  would  greatly  assist  us  in  solving  some  of 
our  social  questions,  while  at  the  same  time  we  would  be 
helped  in  our  future  planning  for  the  betterment  of  the 
citizenry  of  coming  generations.  The  time  has  come  to 
requisition  science  and  draft  scientists  to  help  us  in  the 
great  battle  for  social  regeneration  and  racial  advancement. 

THE  MORAL  OUTLOOK 

There  is  no  doubt  but  that  America  needs  a  moral  awaken- 
ing. The  World  War  probably  did  not  last  long  enough  to 
give  us  our  baptism  of  fire ;  we  no  doubt  have  much  uncon- 
sumed  dross  as  a  nation  —  dross  from  which  we  sadly  need 
to  be  purged.  We  stand  in  need  of  a  great  spiritual  awaken- 
ing —  a  real  national  revival.  Grave  moral  problems  of  vice 
and  its  regulation  and  control  on  the  one  hand,  and  the  pres- 
ent and  future  status  of  the  church  as  a  source  of  spiritual 
inspiration  and  teaching  on  the  other,  challenge  all  that  is 
best  in  the  American  people  to  arise  and  make  a  powerful 


6  RACE  DECADENCE 

twentieth-century  re-statement  of  religious  truth  —  so  to 
illuminate  current  Christianity  as  to  turn  religion  into  a  great 
practical  and  spiritual  searchlight  that  will  become  at  once 
our  guiding  star  of  national  destiny  and  at  the  same  time 
unfailingly  attractive  to  that  great  body  of  honest,  earnest, 
and  truth-loving  people  who  constitute  the  present  backbone 
and  the  future  hope  of  the  American  Republic. 

Before  we  can  comprehend  the  pressing  importance  and 
serious  aspect  of  our  moral  problem,  we  must  know  some- 
thing of  the  laws  of  heredity  —  we  must  understand  the 
significance  of  increasing  mental  deterioration.  We  must 
recognize  the  fact  that  moral  character  is  largely  a  matter 
of  heredity.  A  knowledge  of  the  comparative  influence  of 
heredity  and  environment,  in  the  development  of  character 
and  citizenship,  will  assist  us  in  the  development  of  a  broader 
and  saner  perspective  —  larger  viewpoint  —  which  will,  in 
turn,  greatly  help  us  in  formulating  and  executing  our  larger 
and  more  far-reaching  plans  for  spiritual  uplift  and  moral 
betterment.  In  other  words,  the  racial  and  eugenic  discus- 
sions of  Part  ii  of  this  book  have  a  direct  bearing  on  almost 
every  phase  of  our  many  social  and  moral  problems';  and  a 
better  understanding  of  these  biological  facts  promises 
greatly  to  assist  us  in  rightly  settling  our  numerous  questions 
of  social  and  moral  betterment. 

These  biologic  facts  of  race,  heredity,  and  inborn  character 
constitute  the  very  foundation  and  background  which  every 
intelligent  crusader  for  truth  and  righteousness  must  possess, 
in  order  to  attain  that  efficiency  and  permanent  success  which 
such  a  good  and  glorious  cause  so  worthily  deserves.  The 
time  has  come  for  science  and  "  uplift "  to  join  hands. 

Modern  reform  must  divest  itself  of  superstition;  the 
enthusiasm  of  ignorance  is  a  false  inspiration;  the  uplift 
movement  built  on  error  is  a  delusion;  and  the  hope  of  an 
improved  and  glorified  citizenship  can  only  be  realized  by 


WHAT  AILS  UNCLE  SAM?  7 

facing  the  facts  —  by  courting  the  truth  and  turning  on  the 
searchlight  of  scientific  knowledge. 

THE  NATION'S  HEALTH  PROBLEMS 

As  a  nation,  we  have  many  health  problems  not  discussed 
in  those  chapters  which  constitute  Part  I  of  this  book. 
There  are  still  other  phases  of  personal  hygiene,  public 
hygiene,  and  industrial  hygiene  which  press  upon  us  for 
immediate  study  and  solution.  We  have  a  great  call  to  the 
Southland  looking  toward  the  improved  health  of  the  south- 
ern people;  many  of  our  cities  are  in  need  of  better  depart- 
ments of  public  health,  and  the  nation  itself  is  in  sore  need 
of  a  better  co-ordination  of  its  present  health-promoting 
facilities.  There  are  many  phases  of  disease  prevention 
which  should  be  strengthened  and  extended.  We  do  not  yet 
Ifeep  a  national  set  of  books  on  health  —  only  a  part  of  the 
country  has  registration  of  "  vital  statistics."  There  ought 
to  be  a  Secretary  of  Health  in  the  President's  cabinet.  We 
must  give  earnest  attention  to  the  control  of  periodic  epi- 
demics, such  as  those  of  the  "  flu  "  which  have  so  recently 
been  with  us.  These  and  many  other  health  questions  are 
just  as  important  as  those  taken  up  in  this  volume,  but  it  was 
our  purpose  at  this  time  to  concentrate  the  reader's  attention 
on  those  important  phases  of  disease  prevention  which  have 
been  so  neglected  and  which  concern  us  all  in  two  special 
respects:  first,  these  diseases  are  on  the  increase;  and,  sec- 
ond, we  are  not  going  to  make  much  progress  in  overcoming 
these  "  habit  diseases  "  without  hearty  and  intelligent  coop- 
eration on  the  part  of  individual  citizens.  Health,  vitality, 
and  longevity  are  very  largely  dependent  on  heredity.  So, 
notwithstanding  these  and  numerous  other  health  needs  of 
the  nation,  the  most  serious  problems  after  all,  from  a  health 
standpoint,  are  those  outlined  in  the  first  chapters  of  this 
work;  and,  important  as  is  the  question  of  physical  health, 


8  RACE  DECADENCE 

still  more  important  are  those  questions  of  mental  soundness 
and  racial  integrity  which  are  discussed  in  Part  n. 

RACE   HYGIENE 

After  all,  we  must  acknowledge  that  whatever  may  be  our 
political,  industrial,  social,  and  economic  difficulties;  what- 
ever even  our  health  and  hygiene  problems  —  nothing  is  of 
really  more  import  than  the  study  of  race  hygiene  —  race 
betterment.  Eugenics  is  the  painstaking  examination  of  all 
the  facts  and  truths  which  we  possess,  which  will  help  us 
on  the  one  hand  to  stay  the  march  and  multiplication  of  those 
influences  and  individuals  which  weaken  and  deteriorate  the 
race ;  while  on  the  other  hand  it  enables  us  to  lend  aid  and 
give  assistance  to  every  cause  and  every  individual  planning 
and  tending  to  improve,  uplift,  and  strengthen  the  human 
race  as  a  whole,  and  the  superior  races  in  particular. 

Hygiene  is  a  selfish  cause,  which  aims  to  improve  the  pres- 
ent generation ;  eugenics  is  a  truly  altruistic  enterprise  which 
looks  ahead  and  works  for  the  improvement  of  the  next  and 
future  generations. 

Is  the  quality  of  American  citizenship  deteriorating? 
Does  the  melting-pot  really  melt  ?  Has  Uncle  Sam  admitted 
to  our  shores  thousands  —  even  millions  —  of  immigrants 
who  can  never  become  typical,  happy,  and  prosperous  Ameri- 
can citizens  ?  Is  it  a  fact  that  the  children  of  many  of  these 
un-American  aliens  can  never  become  good  Americans  ex- 
cept through  the  slow  process  of  intermarriage,  and  extend- 
ing through  several  generations?  Is  it  a  fact  that  race 
counts  for  more  than  education,  environment,  and  even  de- 
mocracy in  determining  the  character  of  an  individual  and 
the  quality  of  his  citizenship?  Is  it,  or  is  it  not,  a  fact  that 
there  are  certain  races  and  types  of  individuals  who  are  so 
constituted  by  nature  that  they  can  never  rise  to  an  apprecia- 
tion of  American  ideals,  and  can  never  reach  an  intelligent 


WHAT  AILS  UNCLE  SAM?  9 

comprehension  of  American  institutions?  If  these  questions 
can  be  even  partially  answered  in  the  affirmative,  then  the 
time  has  come  —  the  hour  has  struck  —  for  every  real 
American  seriously  to  take  up  the  study  of  these  funda- 
mental facts  of  national  health  and  racial  hygiene,  and  seek 
really  to  understand  what  ails  Uncle  Sam ! 

THE  REMEDY 

We  believe  that  Uncle  Sam  is  suffering  from  a  complica- 
tion of  national  ills ;  we  believe  this  nation  is  afflicted  with  a 
combination  of  acute  organic  diseases  and  chronic  functional 
disorders.  We  believe  the  American  Commonwealth  is  still 
sound  at  heart  —  that  it  possesses  vast  inherent  power  of  vital 
resistance  and  recuperative  energy;  but  blind  national  opti- 
mism will  only  serve  to  cloud  the  diagnosis  and  confuse  the 
treatment.  Ignorant  enthusiasm  —  false  patriotism  —  will 
only  delay  the  recovery  and  interfere  with  the  rapid  con- 
valescence. 

Quack  cure-alls  of  fake  reform  and  false  politics  will  only 
temporarily  ease  the  social  pain  and  sooth  the  national  con- 
science. Beautiful  and  deceptive  political  theories  like  the 
doctrine  of  the  melting-pot  only  serve  to  deceive  and  delude 
us  as  long  as  peace  and  prosperity  remain  undisturbed.  The 
false  gospel  of  socialism,  or  the  disappointing  doctrines  of 
"  strikes  "  and  "  violence,"  only  delude  us  for  a  time.  The 
mirage  of  the  Bolshevist  may  fascinate  for  a  moment,  but 
it  fails  to  quench  the  thirst  and  satisfy  the  hunger  of  a  dis- 
traught people,  or  to  comfort  and  strengthen  a  war-torn 
world. 

Reformers,  politicians,  organizers,  and  agitators  have  had 
their  day  —  their  well-meant  and  ingenuous  schemes  have 
not  yet  brought  us  into  the  promised  land  of  peace  and 
plenty.  All  our  efforts  to  improve  the  national  ills  and  alle- 
viate the  sufferings  of  the  American  people  have  been  too 


10  RACE  DECADENCE 

largely  directed  to  the  -  treatment  of  symptoms  —  isolated 
manifestations  of  the  underlying  diseased  conditions.  We 
have  failed  to  look  the  facts  in  the  face  and  lay  the  ax  at 
the  root  of  the  tree. 

Has  not  the  time  come  to  begin  the  real  examination  of 
Uncle  Sam  and  his  ailments  in  the  spirit  of  a  scientific  inves- 
tigator who  aims  to  go  to  the  bottom  of  the  difficulty  and 
to  discover  the  actual  disease  present  ?  And  as  fast  as  we  do 
detect  the  causes  of  the  nation's  trouble  let  us  fearlessly  apply 
the  known  remedies  which  history,  political  science,  eco- 
nomics, eugenics,  hygiene,  and  ethnology  may  afford. 

The  hour  has  come  when  the  facts  of  organic  evolution  and 
the  biologic  teachings  of  modern  eugenics  should  be  applied 
to  the  great  problems  of  the  national  administration  as  re- 
lates to  immigration,  labor  and  capital,  sanitation,  social 
reforms,  the  colored-race  problem,  poverty,  and  the  other 
great  Questions  of  national  uplift  and  race  betterment. 

SUMMARY  OF  THE  CHAPTER 

1.  A  better  understanding  of  the  basic  race  problems  con- 
cerned  in   American   society   would   contribute   greatly   to 
a  better  solution  of  our  industrial  and  economic  problems. 

2.  A  more  complete  biologic  knowledge  of   the  laborer 
might  greatly  help  the  statesman  and  the  sociologist  in  solving 
the  labor  problem. 

3.  Many  of  our  political  problems  could  be  more  intelli- 
gently handled  and  more  permanently  settled  if  our  politi- 
cians had  a  better  understanding  of  the  real  physical  status 
of  the  American  people. 

4.  Some  of  our  social  questions  can  be  unraveled  only  by 
those  who  possess  a  working  knowledge  of  modern  hygiene 
on  the  one  hand  and  heredity  on  the  other. 

5.  The  racial  composition  of  the  American  people  has  a 
vital  relation  to  the  practical  solution  of  numerous  pressing 
industrial  problems. 


WHAT  AILS  UNCLE  SAM?  II 

6.  Immigration  is  directly  related  to  a  host  of  the  acute 
and  chronic  social  situations  and  industrial  difficulties  of  the 
present  time. 

7.  As  a  people  we  stand  in  need  of  a  great  spiritual 
awakening  —  a  national  revival  —  based  on  the  facts  and 
truths  of  biologic  science. 

8.  Moral  reforms  must  be  based  on  the  facts  of  human 
heredity  and  must  take  due  cognizance  of  human  nature  if 
they  are  to  succeed. 

9.  There  is  immediate  need  of  more  fully  recognizing  the 
nation's  health  problems  and  better  organizing  its  health 
agencies. 

10.  The  crying  need  of  the  hour  is  a  complete  system  of 
"  vital  statistics  "  covering  the  entire  country. 

11.  Race  hygiene  is  the  study  which  should  take  prece- 
dence of  all  other  subjects  in  the  minds  of  the  American 


12.  Race  is  the   fundamental  determiner  of  citizenship. 
There  are  some  white  races  which  are  just  about  as  unfitted 
for  American  citizenship   (in  the  first  generation)   as  are 
the  Orientals. 

13.  The  remedy  for  our  national  ills  will  not  be  found 
in  the  mirage  of  socialism,  or  the  quack  cure-alls  of  fake 
reformers.    We  need  more  education  and  less  agitation. 

14.  Blind  national  optimism,  ignorant  patriotism,  and  the 
delusion  of  the  melting-pot  will  not  deliver  us  —  we  need 
the  sound  facts  of  biologic  science  to  guide  the  nation  in 
working  out  its  social  and  political  salvation. 


CHAPTER  II 
OUR  FIRST  NATIONAL  HEALTH  INVENTORY 

THE  selective  military  draft  gave  us  an  opportunity,  in 
a  way,  to  make  our  first  national  health  inventory. 
Heretofore,  local  health  surveys  have  been  made,  school  chil- 
dren have  been  examined,  life  insurance  companies  have  con- 
ducted investigations  and  made  a  vast  number  of  examina- 
tions, but  these  former  researches  have  either  been  isolated ; 
or,  having  been  conducted  for  some  special  purpose,  were 
more  or  less  discredited  by  the  general  public;  while  there 
were  always  those  who  raised  the  hue  and  cry  that  many  of 
these  investigations  were  merely  carried  on  for  the  purpose 
of  "  making  more  work  for  the  doctors."  At  last,  in  the  dis- 
closures of  the  rejects  of  the  selective  draft,  we  have  a  com- 
prehensive, representative,  and  authentic  report  that  gives  us 
something  of  an  idea  of  the  health  status  of  the  American 
people. 

TWENTY-FIVE    MILLION    AMERICANS    BELOW    PAR 

In  carrying  out  the  provisions  of  the  selective  draft,  the 
medical  examining  boards  of  this  country  examined  about 
5,000,000  men  between  21  and  31  years  of  age.  (See  Fig. 
i.)  Roughly  speaking,  they  found  about  one-third  of  these 
men  to  be  in  such  poor  physical  condition  that  even  the 
superb  physical  training  regime  and  medical  aid  of  the  army 
camps  could  not  be  expected  to  fit  them  for  any  form  of  active 
military  duty.  Of  the  total  number  of  men  examined,  over 
1,000,000  were  rejected  as  unfit  for  service.  The  government 
had  to  say  to  these  military  rejects,  in  substance:  "  You  are 

12 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY        13 

physically  inferior ;  although  young,  you  are  diseased,  defec- 
tive, or  broken  down.  You  are  unfit  to  go  out  to  defend 
your  country  in  time  of  war." 

Now,  if  this  is  the  situation  with  the  young  men  of  the 
country,  from  21  to  31,  what  must  be  the  situation  with  men 
who  are  35  and  40,  or  older.  And  of  still  more  importance  is 
the  answer  to  the  question:  If  the  men  of  America  make 
this  poor  showing,  what  would  be  disclosed  if  we  examined 
5,000,000  women  from  21  to  31  years  of  age?  The  author 
is  of  the  opinion  that  the  women  would  not  show  up  even  as 
well  as  the  men,  and  that  somewhere  from  one-third  to  one- 
half  would  be  rejected  if  equal  standards  were  applied. 

If  this  same  ratio  would  hold  out  —  taking  the  population 
of  America  to  be  in  the  neighborhood  of  100,000,000  —  elimi- 
nating some  of  the  babies  from  the  reckoning  —  it  would 
leave  us  about  25,000,000  youths  and  adults  in  the  United 
States  who  are  below  par  physically,  who  are  constitutionally 
inferior,  and  who  are  in  need  of  immediate  medical  aid. 
The  unfortunate  part  of  this  disclosure  is  the  fact  that  much 
of  this  discovered  defectiveness  is  of  a  hereditary  nature  — 
the  result  of  defective  germ-plasm. 

And  we  are  all  interested,  if  we  do  not  belong  to  this  class, 
in  knowing  what  we  can  do  to  keep  out  of  this  group  of 
physical  defectives  and  bodily  cripples. 

SIGNIFICANCE  OF  THE  DRAFT-DISABILITY  FINDINGS 

Major  Davenport  and  Lieutenant-Colonel  Love  have  made 
a  very  painstaking  study  of  the  data  secured  by  the  medical 
examinations  of  the  military  draft,  and  while  an  enormous 
number  of  men  were  rejected  —  disqualified  for  military  serv- 
ice —  it  is  in  some  degree  comforting  to  know  that  many  of 
the  causes  for  rejection  were  minor  disabilities,  while  others 
were  physical  conditions  that  could  be  corrected  by  medical 
or  surgical  treatment.  These  medical  officers  report  that  only 


14  RACE  DECADENCE 

about  468  men,  per  1,000  examined,  were  more  or  less  defec- 
tive. This  would  indicate  that  a  little  more  than  half  the 
candidates  examined  were  organically  sound  and  in  every 
way  fit  for  military  duty. 

About  two-fifths  of  the  defects  found,  it  should  be  noted, 
were  of  a  mechanical  sort,  such  as  those  having  to  do  with 
the  feet,  bones,  joints,  etc.  The  next  group  most  numerous, 
were  defects  in  the  sense  organs,  followed  by  tuberculosis  and 
venereal  diseases. 

It  is  probably  true  that  fully  90  per  cent  of  the  people 
examined  in  the  army  draft  would  be  fairly  competent  to 
accept  and  discharge  their  duties  in  some  civilian  capacity. 
About  10  per  cent  of  the  total  number  examined  present 
defects  that  would  disqualify  them  for  efficient  service  even 
in  civil  life. 

Of  all  the  many  lessons  that  should  be  learned  from  the 
draft  data  respecting  physical  examinations,  one,  at  least,  that 
we  should  recognize  is  that  of  extending  the  field  of  preven- 
tive medicine  to  cover  the  realm  of  personal  hygiene.  Con- 
cerning this  phase  of  the  subject  a  recent  editorial  in  the 
Journal  of  the  American  Medical  Association,  very  appro- 
priately remarks : 

The  particular  point  of  view  that  is  emphasized  by  these  results 
Is  the  necessity  for  a  much  wider  application  of  individual  preventive 
medicine  than  has  heretofore  been  deemed  necessary.  The  day  is 
past  when  preventive  medicine  consisted  merely  in  attention  to 
water  supplies,  sewerage,  and  general  sanitation.  The  education  of 
the  public  in  the  principles  of  correct  living  and  the  periodic  ex- 
amination of  supposedly  healthy  individuals  must  become  part  of 
our  creed  as  physicians  if  any  great  progress  is  to  be  made  in  the 
prevention  of  disease.  While  the  necessity  for  community  hygiene 
continues  and  still  needs  developing  in  many  quarters,  it  has  been 
clearly  demonstrated  that  general  sanitation  will  carry  us  only  so 
far,  and  that  the  preventive  medicine  of  the  future  must  be  con- 
cerned with  the  individual  much  more  than  has  the  preventive 
medicine  of  the  past.  The  nineteenth  century  was  the  century  of 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY       15 

communal  hygiene;  the  twentieth  century  must  be  the  century  of 
individual  hygiene. 

CAUSES  FOR  REJECTION  IN  THE  DRAFT  EXAMINATIONS 

According  to  an  editorial  in  the  American  Journal  of  Clini- 
cal Medicine  the  causes  of  rejection  at  the  draft  examinations 
in  1917  and  1918  as  reported  by  the  Surgeon-General  of  the 
United  States  Army  were  as  follows : 

Venereal  diseases   938,232 

Heart  disease  564,768 

Diseases  of  the  ear  including  defects  in  hearing 525,600 

Diseases  of  the  eye  including  defects  of  vision 421,704 

Flat-foot     346,392 

Alcoholism    296,640 

Diseases  of  organs  of  locomotion 277,128 

Hernia    209,304 

Diseases  of  the.  skin 174,672 

Underweight    173,160 

Diseases  of  the  respiratory  system 156,600 

Defective  teeth 146,088 

Defects  of  development 132,552 

Non-venereal  disease  of  the  genito-urinary  system 124,992 

Varicose  veins   90,360 

Disease  of  nervous  system  except  as  shown  in  detail 88,848 

General  disease  except  as  shown  in  detail 82,800 

Tuberculosis    76,824 

Varicocele    48,168 

Insufficient  chest  development 45J44 

Disease  of  digestive  system  except  as  shown  in  detail 43,704 

Physical  debility   38,880 

Curvature  of  the   spine 36,144 

Overweight    31,608 

Hemorrhoids 22,608 

Underheight    21,096 

Disease  of  circulatory  system  except  as  shown  in  detail 7,56o 

Injuries    207,792 

Rejected  for  causes  not  physical 1,721,304 

MILITARY  REJECTS  BEFORE  THE  WORLD  WAR 

Between  1914  and  1917  the  recruiting  surgeons  rejected  77 
per  cent  of  the  205,281  applicants  for  the  army.  That  is, 


1 6  RACE  DECADENCE 

during  those  years,  just  about  75  per  cent  of  the  applicants 
were  found  to  be  physically  unfit  for  military  service.  After 
the  declaration  of  war  against  Germany  the  standards  of  the 
war  department  were  greatly  lowered,  but  even  with  this  low- 
ering of  standards  the  first  examinations  of  the  drafted  men 
brought  about  a  rejection  of  29.11  per  cent.  After  the 
accepted  candidates  were  sent  to  the  training  camps  and  were 
re-examined  5.8  per  cent  of  the  accepted  men  were  rejected 
as  the  result  of  this  second  examination.  There  seemed  to 
be  little  difference  between  the  candidates  from  city  and 
country.  The  rejects  were  about  equally  divided  as  regards 
living  in  rural  or  urban  communities.  So  the  matter  stands 
thus:  About  25  per  cent  of  the  candidates  were  rejected  by 
the  draft  surgeons,  and  the  re-examining  military  surgeons 
rejected  an  additional  6  per  cent,  thus  bringing  the  total  of 
rejects  up  to  31  per  cent,  or  almost  one-third  of  the  total 
number  of  men  called. 

RECOMMENDATIONS  OF  THE  PUBLIC  HEALTH  SERVICE  RESPECT- 
ING THE  MILITARY  REJECTS  OF  THE  SELECTIVE  DRAFT 

Defective  eyesight. —  Be  sure  that  your  vision  is  corrected 
by  properly  fitted  glasses.  Have  this  done  by  an  eye  special- 
ist, eye  dispensary,  or  eye  hospital.  Do  not  try  to  fit  cheap 
glasses  to  your  own  eyes.  Eyestrain  from  badly  fitted  glasses 
may  in  time  seriously  affect  your  eyesight  or  health. 

Teeth. —  Decayed  roots,  infected  gums,  decayed  teeth, 
irregular  teeth  which  cannot  grind  may  cause  many  forms  of 
serious  disease  and  should  have  immediate  attention.  Artifi- 
cial teeth  or  bridges  should  be  secured  if  the  grinding  teeth 
are  missing,  for  if  you  do  not  properly  chew  your  food  your 
health  may  be  affected.  Brush  the  teeth  thoroughly  at  least 
twice  a  day.  If  you  have  defective  teeth,  or  much  gold  work, 
or  many  fillings  in  your  mouth,  X-ray  to  discover  possible 
root  infection  is  a  wise  precaution,  especially  if  you  have 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY       *7 

rheumatism  or  any  joint  trouble,  for  which  other  causes  can- 
not be  found. 

Feet. —  Aside  from  paralysis,  clubfoot,  or  deformities  re- 
sulting from  injuries,  etc.,  most  foot  troubles  are  due  to 
improperly  fitting  shoes,  improper  position  in  walking,  lack 
of  exercise,  and  weakness  of  the  muscles  in  the  fore  part  of 
the  leg  that  support  the  arch  of  the  foot.  Properly  fitting 
shoes  of  correct  shape,  with  a  straight  inner  edge  (the 
Munson  army  last  is  a  good  style)  will  help  to  correct  weak 
feet,  bunions,  corns,  calluses,  and  painful  joints. 

Exercise  the  toe  muscles  by  working  the  toes  up  and  down 
over  the  edge  of  a  thick  board,  thirty  times  daily.  Stand  with 
feet  parallel  and  somewhat  apart,  with  great  toes  firmly  grip- 
ping the  ground.  Without  bending  the  knees  or  moving  the 
feet  rotate  the  thighs  outward  repeatedly.  This  is  chiefly 
doVie  by  strong  contraction  of  the  great  muscles  of  the  back 
of  the  thigh  and  seat. 

Improve  your  general  health;  take  all-round  exercise  to 
strengthen  your  body.  Bathe  the  feet  daily.  See  a  surgeon 
if  these  simple  measures  are  not  sufficient.  The  arches  found 
in  the  shops  will  not  correct  flat-foot.  They  merely  act  as 
crutches.  Hammertoe,  bunion,  and  many  other  defects  can  be 
corrected  by  a  surgeon.  Painful  feet  may  be  due  to  infection 
in  tooth  sockets  or  tonsils  —  search  for  such  conditions  should 
be  made.  Mere  flatness  of  the  foot,  without  pain  or  other 
deformity  may  be  of  no  importance. 

Underweight. —  Underweight  is  often  due  to  irregular 
habits  of  eating  and  sleeping  and  lack  of  regular  exercise. 
Have  a  thorough  examination  at  intervals  by  a  competent 
physician,  or  in  dispensary  or  clinic,  to  determine  whether 
or  not  any  serious  disease  exists  (especially  hookworm  or 
tuberculosis.)  Eat  freely  of  fat-forming  foods. 

Overweight. —  Secure  as  much  regular  exercise  as  possible. 
Be  thoroughly  examined  for  evidence  of  disease.  Extreme 


1 8  RACE  DECADENCE 

overweight,  especially  at  middle  life,  produces  as  high  a 
death-rate  as  heart  disease.  Cut  down  the  fat-forming  foods, 
such  as  bread,  butter,  cereals,  sugars,  and  fats ;  substitute 
more  green  vegetables  and  fruits. 

Hernia,  or  Rupture. —  Operation  is  often  advisable.  Con- 
sult a  competent  surgeon  and  confer  with  your  local  physician. 

Piles,  or  Hemorrhoids. —  These  often  are  caused  by  con- 
stipation and  lack  of  exercise.  Do  not  use  drugs  or  purga- 
tives. Plenty  of  bulky  food,  bran  bread  or  biscuits,  fruits, 
lettuce,  spinach,  cabbage,  Brussels  sprouts,  carrots,  turnips, 
celery,  tomatoes,  salsify,  onions,  and  parsnips  will  tend  to 
correct  constipation.  If  piles  are  severe  operation  will  help, 
but  the  original  cause  should  be  removed  by  proper  diet. 
Agar-agar,  harmless  and  not  a  drug,  can  be  had  at  any  drug- 
store. Take  a  teaspoonful  three  times  a  day.  Mineral  oil 
is  also  helpful  and  harmless. 

Varicocele  and  "varicose  veins. —  If  severe  enough  to  cause 
rejection,  operation  may  be  performed.  Upbuild  general 
health  by  exercise  and  nourishing  diet  and  fresh  air.  A  sus- 
pensory bandage  is  often  required.  Support  varicose  veins  by 
bandage  or  stockings.  At  times  removal  by  operation  may  be 
necessary ;  but  use  great  caution  regarding  this. 

Bladder,  kidney,  and  urinary  troubles. —  Go  to  your  phy- 
sician or  to  a  clinic  and  place  yourself  under  careful  medical 
supervision.  Regulation  of  your  diet,  work,  and  activities 
may  be  all  that  is  necessary  but  your  condition  should  be 
watched  from  time  to  time.  Albumin  in  the  urine  may  be 
temporary,  but  should  always  be  followed  up  and  examina- 
tions made  at  intervals.  Give  the  benefit  of  the  doubt  to  your 
kidneys  and  live  a  temperate  and  healthful  life,  avoiding 
stimulants,  excess  of  meat,  and  overeating  generally.  Be 
examined  periodically.  Sugar  in  the  urine  calls  for  careful 
medical  supervision  and  regulation  of  diet  and  periodic  ex- 
amination by  a  physician. 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY       19 

Ear  trouble. —  In  case  of  discharge  from  the  ear  see  a 
specialist  or  go  to  an  ear  clinic.  Do  not  neglect  such  a  con- 
dition, which  may  infect  other  parts  of  your  body. 

Heart  affections. —  A  man  with  an  imperfect  heart  may 
not  be  fit  for  military  service,  but  with  proper  regulation  of 
diet,  exercise,  work,  and  rest,  his  heart  may  carry  him  to  old 
age.  Avoid  stimulants  and  tobacco ;  be  temperate  in  the  use 
of  tea  and  coffee,  avoid  excesses  of  all  kinds ;  eat  moderately ; 
avoid  heavy  meals  at  night ;  get  plenty  of  fresh  air ;  exercise 
daily  in  the  open,  but  be  careful  not  to  overfatigue  your  heart 
or  circulation  —  walking  and  gentle  hill  climbing  are  good, 
but  never  when  they  cause  pain  in  the  chest  or  shortness  of 
breath.  Avoid  dissipation  and  undue  excitement.  If  there 
is  breathlessness,  dropsy,  or  dizziness,  careful  medical  super- 
vision is  necessary.  All  damaged  hearts  should  be  examined 
att least  once  a  year  by  a  physician  and  the  condition  noted. 
Irregular  action  of  heart  in  some  cases  is  of  little  importance ; 
in  others  it  is  serious  and  medical  observation  is  important  to 
settle  this. 

High  blood-pressure. —  This  may  be  temporary,  but  should 
be  watched  and  the  life  regulated  as  above,  especially  avoid- 
ing physical  and  mental  overstrain  and  dissipation.  Eat  little 
meat;  avoid  stimulants,  tobacco,  and  overeating. 

Lung  trouble. —  Where  tuberculosis  is  suspected  consult  a 
competent  physician  and  follow  orders  strictly.  The  basis  of 
the  treatment  is  abundant  fresh  air  and  nourishing  diet,  such 
as  bread  and  butter,  cereals  and  fats,  but  do  not  neglect  green 
vegetables  and  fruits.  Avoid  alcohol  and  tobacco.  Do  not 
take  patent  medicines  or  advertised  remedies,  or  patronize 
advertising  quacks.  Avoid  fatigue,  or  physical  or  mental 
strain.  Do  not  take  any  chances.  Report  to  the  health  officer 
or  health  department  of  your  district.  They  will  be  glad  to 
counsel  you. 

Rheumatism. — This  may  be  caused  by  infection  in  tonsils, 


20  RACE  DECADENCE 

teeth,  nasal  cavities,  or  elsewhere.  Liniment  will  not  cure  it. 
Be  examined  by  a  physician  or  dentist  and  have  the  infection 
removed. 

Syphilis  —  Gonorrhea. —  Thoroughgoing,  persistent  treat- 
ment is  necessary  for  your  protection  and  for  the  protection 
of  the  members  of  your  family  as  well  as  that  of  your  com- 
munity. In  large  cities  clinics  for  the  treatment  of  these 
diseases  are  available  for  those  without  funds. 

Alcohol. —  Alcohol,  as  ordinarily  taken,  is  not  a  stimulant 
but  a  depressing  drug.  Your  brain  and  nervous  system  gov- 
ern your  body.  Alcohol  not  only  reduces  the  efficiency  of  a 
nation,  but  life  insurance  experience  has  shown  that  the 
death-rate  among  steady  drinkers  supposed  to  be  temperate  — 
even  within  the  bounds  of  so-called  moderation  —  is  nearly 
double  that  among  average  people.  Drink  may  lead  you  into 
trouble,  possibly  a  miserable  death.  Why  deliberately  expose 
yourself  to  this  sort  of  machine-gun  fire? 

Nervous  and  mental  diseases. —  Such  conditions  should  be 
closely  observed  by  your  physician  or  at  some  clinic  for  nerv- 
ous diseases.  Some  nervous  diseases  are  due  to  bad  mental 
habits,  to  fear,  failure  to  take  a  courageous  grip  of  life  and 
forget  one's  troubles.  Many  nervous  diseases  may  be  caused 
by  physical  conditions  which  should  be  sought  for  and  cured 
by  a  thorough  medical  examination  and  treatment. 

Miscellaneous  conditions. —  Nose  and  throat  troubles ;  gall- 
bladder trouble ;  chronic  appendicitis ;  skin  affections  —  all 
such  conditions  should  have  immediate  medical  investigation. 
If  you  have  no  family  physician  or  if  your  means  are  limited, 
seek  hospital  or  dispensary  treatment. 

HEALTH  OF  SEDENTARY  PEOPLE 

A  few  years  ago  the  New  York  City  Health  Department 
started  out,  systematically  to  examine  all  its  employees.  One 
would  naturally  think  these  employees  would  be  a  trifle 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY       21 

healthier  than  the  average  of  men  and  women  who  are  en- 
gaged in  sedentary  occupations.  They  had  no  definite 
physical  complaints  and  no  aches  and  pains  which  led  them  to 
consult  a  physician.  They  simply  took  the  annual  examina- 
tion which  the  department  offers  its  employees. 

The  findings  were  somewhat  disconcerting,  inasmuch  as 
they  suggest  that  about  25  per  cent  of  the  men  and  women 
who  work  in  offices  have  more  or  less  kidney  trouble  —  have 
albumin  in  the  urine.  They  may  even  be  said  to  have  incipient 
Bright's  disease. 

We  have  no  reason  to  believe  but  that  any  typical  business 
organization  or  commercial  establishment  in  this  country 
would  show  approximately  the  same  results  if  they  were  ex- 
amined in  this  way.  A  summary  of  these  results  may  be 
giyen  as  follows : 

Of  the  2,000  examined  in  this  series,  2.5  per  cent  had 
albuminuria  with  high  blood-pressure.  Five  of  the  2,000  had 
diabetes;  8.8  per  cent  of  the  men  and  6.7  per  cent  of  the 
women  had  organic  heart  disease.  In  the  vast  majority  of 
instances  the  patients  were  not  aware  of  any  existing  abnor- 
mality in  the  heart ;  8.7  per  cent  of  the  men  and  5.5  per  cent 
of  the  women  had  lung  disease,  mostly  tuberculosis;  18.9 
per  cent  of  the  men  examined  and  21.2  per  cent  of  the  women 
were  much  overweight ;  and  pronounced  overweight  has  a 
marked  effect  in  decreasing  the  length  of  life.  (See  Fig.  2.) 

Of  the  men  11.4  per  cent  exhibited  high  blood-pressure. 
Only  4  per  cent  of  the  women  had  high  blood-pressure.  On 
the  other  hand,  a  larger  proportion —  17.7  per  cent  —  of  the 
women  suffered  from  low  blood-pressure.  Of  the  women  7.5 
per  cent  and  of  the  men  4.1  per  cent  had  complained  of 
indigestion.  More  than  10  per  cent  were  constipated.  Thirty- 
three  women  had  varicose  veins.  Fifty  had  weak,  painful,  or 
flattened  arches.  Two  men  had  painful  arches,  four  varicose 
veins.  Twice  as  many  women  as  men  complained  of  headache. 


MINOR  TENDENCIES 
TOWARD  DISEASE 
36  PERCENT 


MODERATE  TO  SERIOUS 
TENDENCY  TOWARD 
DISEASE  50  PER  CENT 


Fig.  2.    Results  of  examining  supposedly  well  people 

Results  obtained  in  the  examination  of  several  thousand 
supposedly  healthy  individuals  (average  age  30  years)  em- 
ployed in  banks,  insurance  offices,  factories,  mercantile  estab- 
lishments, and  other  industrial  concerns.  Four  per  cent 
were  found  normal ;  36  per  cent  exhibited  minor  tendencies 
toward  disease ;  50  per  cent  showed  from  moderate  to 
severe  symptoms  of  approaching  disease;  while  10  per  cent 
were  found  to  be  already  suffering  from  some  serious  or 
advanced  physical  ailment. 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY       23 

Thirty-five  nurses,  fifteen  physicians,  fifteen  laboratory 
workers,  and  sixteen  others  had  been  vaccinated  against 
typhoid ;  while  10  per  cent  of  the  employees  were  found  in 
better  condition  at  this  examination  than  they  were  in  the 
previous  year. 

ARE  THE  MODERN  RACES  DECLINING  IN  STATURE? 

It  has  been  asserted  that  the  French  people  are  short  of 
stature  because  the  tall  Frenchmen  were  all  killed  off  in  the 
Napoleonic  wars,  but  careful  investigation  hardly  warrants 
believing  this  statement  The  author  seriously  doubts  if  there 
is  occurring,  or  has  occurred  in  recent  times,  much  of  a  short- 
ening of  stature  among  the  civilized  races,  though  we  must 
freely  admit  that,  as  compared  with  some  ancient  races,  we 
must  be  growing  shorter,  or  else  these  giant  strains  have,  for 
some  reason,  largely  disappeared  from  the  face  of  the  earth. 
(See  Fig.  3.) 

History  tells  us  (1555)  of  three  English  brothers,  Og,  Gog, 
and  Magog,  who  were  London  Tower  guards,  and  all  three 
were  over  8  feet  in  height.  The  Duke  of  York  is  said  to 
have  had  a  yeoman  8  feet  6  inches  tall.  O'Brien,  the  Irish 
giant,  was  8  feet  4  inches  tall,  and  his  skeleton  is  on  exhibition 
today  in  the  Royal  Museum.  Dr.  Adam  Clark  tells  of  meas- 
uring a  man  8  feet  6  inches  high.  There  is  a  record  of 
another  Scotch  giant  8  feet  3  inches  tall,  and  Frederick  the 
Great  is  reputed  to  have  had  a  whole  regiment  of  giants. 

Even  before  the  World  War,  England  lowered  her  military 
stature  standards  and  requirements  three  or  four  times  in 
fifty  years,  and  there  are  some  anthropologists  who  claim  that 
the  stature  of  the  civilized  nations  has  really  decreased.  It 
is  also  a  significant  fact  that  in  the  Spanish-American  War 
25  per  cent  of  all  applicants  for  the  United  States  Army  were 
rejected  on  this  one  ground  —  they  were  not  tall  enough. 
And,  in  this  connection,  we  must  not  overlook  the  fact  that 


24  RACE  DECADENCE 

stature  is  very  definitely  a  matter  of  inheritance  —  it  is  regu- 
lated by  precise  and  well-known  laws. 

LOOKING  BACKWARD 

When  we  stop  to  consider  the  large  number  of  people  who 
are  constantly  sick  in  this  country  every  year,  when  we  pause 
to  consider  that  over  100,000  Americans  annually  die  of 
pneumonia;  that  there  are  over  250,000  people  sick  in  New 
York  City  all  the  time ;  that  many  diseases  seem  to  be  increas- 
ing instead  of  decreasing ;  that  the  health  authorities  of  the 
country  estimate  that  there  are  nearly  1,000,000  needless  and 
premature  deaths  in  America  each  year ;  when  we  pause  to 
consider  this  situation  in  the  presence  of  the  fact  that  medical 
science  has  made  great  progress  in  recent  years  and  that  we 
have  almost  200,000  doctors  and  health  specialists  at  work 
constantly  looking  out  for  the  welfare  of  the  people;  well, 
whatever  our  past  gains  we  have  much  yet  to  gain,  before 
we  have  cause  for  pride  in  our  national  health.  In  the  United 
States  today  about  15  persons  out  of  every  1,000  die  annually. 
Even  if  we  only  estimate  the  value  of  a  human  life  at  $5,000 
our  annual  economic  loss  from  premature  deaths  alone  would 
be  $5,000,000,000. 

The  world's  death-rate  is  considerably  over  100,000  persons 
a  day.  The  short-lived  families  seem  to  be  increasing,  while 
the  long-lived  families  are  decreasing,  for  it  is  a  well-known 
biologic  fact  that  longevity  runs  in  families  —  as  it  also  does 
in  races. 

There  is  no  doubt  but  that  some  tribes  of  the  human  race 
used  to  live  much  longer  than  they  do  now.  There  are  in 
history  some  remarkable  accounts  of  longevity.  We  not  only 
know  they  had  giants  in  ancient  times  because  of  the  records, 
but  we  find  their  skeletons  and  so  we  know  the  records  are 
more  or  less  accurate.  Of  an  ancient  king,  about  1500  B.C. 
we  read:  "  For  only  Og  king  of  Bashan  remained  of  the 


Fig.  3.  Are  the  giants  disappearing?   Captain  George  Auger, 
8  feet   4  inches  tall,  and  Lady  Little,  but  30  inches  high 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY      2$ 

remnant  of  giants;  behold,  his  bedstead  was  a  bedstead  of 
iron;  is  it  not  in  Rabbath  of  the  children  of  Ammon?  nine 
cubits  was  the  length  thereof,  and  four  cubits  the  breadth  of 
it,  after  the  cubit  of  a  man."  (Deut.  3  :ii.)  Now  according 
to  the  reference  tables  a  cubit  of  that  time  is  eighteen  inches. 
This  would  make  King  Og's  bed  about  13.5  feet  in  length. 
Another  quotation  from  the  Good  Book  sheds  light  on  the 
physical  condition  of  the  Jewish  people.  About  the  middle 
of  the  fifteenth  century  B.C.,  the  Psalmist  says:  "He 
brought  them  forth  also  with  silver  and  gold ;  and  there  was 
not  one  feeble  person  among  their  tribes."  (Ps.  105:37.) 

Abraham,  the  father  of  the  Jewish  people,  lived  to  be  175 
years  of  age  according  to  the  records.  Pliny  tells  of  an 
Italian  district  which  had  130  persons  of  100  years  of  age, 
57fvere  1 10,  2  persons  were  125  years  old,  4  were  130,  4  were 
135,  and  there  were  3  people  in  the  community  who  were  140 
years  of  age.  John  Korin,  a  Hungarian,  even  in  compara- 
tively recent  times,  lived  to  the  extraordinary  age  of  172 
years,  while  a  woman  died  in  Moscow,  in  1848  who  was 
reputed  to  be  168  years  old.  In  1670  Henry  Jenkin,  an 
Englishman,  died  at  169.  J.  Neffingham,  also  an  Englishman, 
died  in  1757  at  144,  while  Lord  Raleigh  is  authority  for  the 
statement  that  the  Countess  Desmond  appeared  in  court  in 
1614,  hale  and  hearty  at  the  age  of  140  years  Thomas  Parr, 
familiarly  known  as  "  Old  Parr,"  a  native  of  Scotland,  who 
lived  a  healthy  and  uneventful  life  up  to  the  age  of  152 
years,  was  then  discovered  by  an  English  count  who,  because 
of  his  great  age,  took  him  to  London  to  exhibit  him  to  his 
friends.  Charles  i  heard  of  this  remarkable  subject,  and 
brought  him  to  the  court,  where,  after  a  sumptuous  feast, 
"  Old  Parr  "  promptly  died  of  indigestion,  but  not  from  old 
age  as  the  post-mortem  examination  showed  no  signs  at  all  of 
physical  degeneration.  Many  of  these  remarkable  persons 
certainly  must  have  belonged  to  long-lived  families  —  even 


26  RACE  DECADENCE 

though,  in  some  instances,  they  may  not  have  actually  been  as 
old  as  reputed. 

It  seems  that  Seneca  was  not  far  wrong  when  he  said, 
"  Man  does  not  die,  he  kills  himself."  Many  of  the  early 
Christian  Fathers  and  ancients  who  limited  themselves  to  a 
most  frugal  diet,  consisting  mainly  of  bread  and  water, 
attained  to  a  remarkable  age.  St.  Anthony  lived  105  years ; 
James  the  Hermit,  104  years;  Arsenius,  the  tutor  of  the 
Emperor  Arcadius,  95  years,  and  St.  Epiphanius,  92  years. 
Cornaro,  the  famous  Italian  writer  on  dietetics,  was  given  up 
to  die  at  40,  but  adopted  an  abstemious  diet,  and  lived  to  be 
1 02  years  old. 

The  British  statesman,  Gladstone,  enjoyed  vigorous  health 
and  did  his  usual  work  at  83.  The  poet,  Bryant,  did  excellent 
work  at  80.  Galileo,  at  70  years,  was  an  excellent  student, 
and  a  hard  worker.  Michelangelo  designed  the  rebuilding  of 
St.  Peter's  and  was  on  the  job  in  charge  of  the  work  at  the 
age  of  89.  He  painted  his  masterpiece,  "  The  Conversion  of 
St.  Paul  "  at  75,  and  worked  on  until  his  death  at  90.  Titian 
lived  to  be  100  years  of  age,  and  at  87  produced  his  master- 
piece, "  The  Last  Supper."  Stradivarius  made  his  most 
famous  violin  at  90.  Hippocrates  lived  to  be  99  years  of  age. 
Sir  Isaac  Newton  worked  up  to  85.  Socrates  was  70  at  the 
time  he  was  murdered. 

LOOKING  FORWARD 

While  a  study  of  the  causes  for  military  rejection  sup- 
plies us  with  food  for  serious  thought,  at  the  same  time  they 
suggest  to  us  that  we  are,  after  all,  far  from  being  a  physically 
decadent  nation.  Many  of  these  causes  for  military  rejection 
were  minor,  trivial  —  that  is,  from  the  standpoint  of  civilian 
activity  and  efficiency.  On  the  other  hand  many  of  them 
were  removable  or  curable,  by  proper  medical  attention  or 
surgical  procedure.  While  the  results,  on  the  whole,  are  not 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY       27 

alarming,  they  challenge  us  to  arise  and  take  proper  steps  to 
set  our  physical  house  in  better  order.  The  most  serious 
aspect  of  this  whole  question  is  the  fact  that  such  a  large  part 
of  our  def  ectiveness  is  to  a  certain  degree  hereditary,  and  that 
it  is  destined  to  be  passed  on  to  succeeding  generations. 

The  major  disabilities  disclosed  by  the  medical  examina- 
tions of  the  selective  draft  —  the  more  grave  disorders  and 
alarming  conditions  found  —  will  be  studied  in  subsequent 
chapters,  in  which  some  of  these  more  serious  maladies  are 
considered  as  a  part  of  the  discussions  of  this  work:  such 
diseases  as  tuberculosis,  cancer,  venereal  diseases,  Bright's 
disease,  cardio-vascular  disorders,  etc. 

SUNDRY  EVIDENCE  OF  RACE  DECADENCE 

^t  is  not  only  in  the  realm  of  degenerative  and  old-age 
diseases  that  we  see  evidences  of  race  deterioration.  We  find 
it  in  connection  with  many  other  grave  diseases  and  minor 
disorders.  In  many  different  ways  we  observe  a  lowering  of, 
the  vital  resistance  of  the  human  species. 

For  instance,  take  the  matter  of  teeth.  There  is  no 
denying  the  fact  that  the  white  races  in  particular  are,  from 
generation  to  generation,  exhibiting  a  tendency  to  tooth  decay 
that  is  alarming.  While  it  may  be  entirely  true  that  much 
of  this  trouble  is  due  to  the  eating  of  too  much  soft  foods, 
thus  failing  to  give  the  gums  proper  massage  and  friction, 
all  of  which  results  in  bringing  about  a  more  or  less  diseased 
condition  of  the  gums,  which  sometimes  goes  so  far  as 
to  develop  into  pyorrhea;  nevertheless,  notwithstanding  our 
failure  to  take  proper  care  of  the  gums,  the  author  is  of  the 
opinion  that  there  is  an  inherited  tendency  toward  inferior 
teeth  in  many  strains  of  American  stock.  In  other  words, 
we  believe  that  soundness  of  teeth  is  not  merely  a  matter  of 
hygienic  care,  it  is  also  a  matter  of  inheritance.  Take,  for 
instance,  the  teeth  of  the  Negro  race,  as  we  see  it  in  America. 


28  RACE  DECADENCE 

Sometimes,  with  little  or  no  care,  we  see  magnificent  sets 
of  teeth  among  Negroes.  So  that  we  cannot  but  conclude 
that  heredity  is  directly  concerned  in  the  quality  of  the 
individual's  teeth. 

Another  matter  that  is  interesting  in  this  connection  is  the 
question  of  baldness.  How  many  men  we  see  now,  bald 
at  middle  life.  And  even  the  women  are  more  and  more 
having  to  resort  to  artificial  hair  to  piece  out  their  head 
adornment.  While  the  subject  of  bald  heads  is  one  that  has 
received  much  attention  at  the  hands  of  the  medical  profes- 
sion, it  is  a  question  by  no  means  satisfactorily  solved  at  the 
present  time,  and  while  it  is  not  a  serious  symptom  as  regards 
race  decadence,  it  is  one  of  those  little  straws  that  show  which 
way  the  racial  winds  are  blowing.  At  least  it  is  somewhat  dis- 
concerting to  contemplate,  sometime  in  the  not  distant  future, 
when  we  will  be  what  one  alarmist  has  denominated  "  a  tooth- 
less, hairless  race." 

SUMMARY  OF  THE  CHAPTER 

1.  In  the  selective  military  draft  the  nation  took  its  first 
health  inventory.     This  was  our  first  comprehensive  and 
authentic  efficiency  audit. 

2.  Practically  one-third  of  the  drafted  men  from  21  to  31 
years  of  age  were  rejected  for  military  duty. 

3.  This  same  ratio  applied  to  the  nation  (excepting  the 
very  young  and  the  very  old)  means  that  we  have  25,000,000 
citizens  below  par. 

4.  About  one-half  of  the  men  examined  were  seriously  de- 
fective.   The  balance  had  only  minor  or  curable  medical  and 
surgical  ailments. 

5.  About  10  per  cent  of  the  men  examined  had  defects 
which  would  disqualify  them  for  any  service  even  in  civil 
life. 

6.  The  one  great  lesson  to  be  learned  from  the  draft  data 
is  that  of  the  value  of   the  annual   medical   examination. 
Everybody  should  be  examined  once  a  year. 


OUR  FIRST  NATIONAL  HEALTH  INVENTORY      29 

7.  Sanitary  science  alone  will  not  keep  the  nation  well  and 
fit ;  personal  hygiene  is  equally  important. 

8.  Venereal  disease  constituted  the  leading  cause  for  re- 
jection ;  with  heart  disorders  next.    Almost  a  million  with  the 
former  and  over  half  a  million  with  the  latter. 

9.  Almost  2,000,000  men  were  rejected  for  causes  not 
physical.     This  group  includes  those  found  insane,  feeble- 
minded, etc. 

10.  For  a  number  of  years  before  the  World  War  77  per 
cent  of  applicants  for  the  army  were  rejected. 

11.  As  regards  the  comparison  between  city  and  country 
there  appears  to  be  little  difference  in  the  per  cent  of  military 
rejects. 

12.  It  appears  that  many  of  the  causes  for  rejection  are 
curable,  such  as  defects  of  the  teeth,  feet,  eyes,  ears,  and 
certain  common  disorders  of  nutrition,  together  with  hernia, 
venereal  diseases,  and  nervous  disorders. 

f3.  The  New  York  City  Health  Department  examined  its 
force  with  the  following  results:  Twenty-five  per  cent  of 
these  sedentary  workers  have  more  or  less  kidney  trouble ; 
2.5  per  cent  showing  albumin  in  the  urine  with  high  blood- 
pressure. 

14.  An  ancient  strain  of  giantism  seems  to  be  dying  out 
of  the  modern  races;  though  it  is  probable  that  stature  is  not 
markedly  decreasing  at  present. 

15.  England  has  lowered  her  military  standards  for  height 
three  to  four  times  in  fifty  years;  and  in  the  Spanish- Amer- 
ican War  25  per  cent  of  applicants  were  rejected  because 
they  were  not  tall  enough. 

1 6.  Over  100,000  Americans  die  each  year  of  pneumonia; 
250,000  people  are  sick  in  New  York  City  all  the  time; 
and  there  are   1,000,000  premature  deaths  in  this  country 
annually. 

.  17.  In  the  United  States  15  people  out  of  every  1,000  die 
each  year.  Estimating  a  life  at  only  $5,000,  this  means  an 
annual  economic  loss  of  $5,000,000,000. 

1 8.  The  world's  death-rate  is  over  100,000  persons  a  day. 

19.  There  can  be  little  doubt  that  people  used  to  live  longer 
than  they  do  now.     Modern  "  man  does  not  die,  he  kills 
himself."" 


30  RACE  DECADENCE 

20.  Many  of  the  ancients  did  good  work  until  they  were 
75  or  100  years  old. 

21.  The  military  draft  data,  while  supplying  food  for  seri- 
ous thought,  shows  that  we  are  far  from  being  a  decadent 
nation. 

22.  Bad  teeth  and  bald  heads  are  on  the  increase  among 
the  American  people.    Heredity  is  a  factor  in  the  causation  of 
these  and  many  other  physical  defects. 


CHAPTER  III 
POSTPONING  YOUR  FUNERAL 

THE  time  has  come  when  the  American  citizen  should 
begin  to  pay  some  attention  to  the  vital  statistics  of  the 
nation ;  when  he  should  wake  up  and  begin  to  take  a  real 
interest  in  postponing  his  own  funeral.  Somewhere  in  the 
future  there  will  come  a  time  when  the  government  will  not 
allow  people  to  die  promiscuously  and  prematurely  without 
inquiry  —  when  the  citizen  will  not  be  allowed  to  commit  sui- 
cide on  the  instalment  plan.  The  time  is  certainly  coming 
when,  every  time  an  American  citizen  dies  under  50  years 
of  age,  a  coroner's  inquiry  will  be  held  to  ascertain  the  cause 
of  death  and  place  the  responsibility. 

VITAL  STATISTICS 

Someone  has  called  vital  statistics  "  humanity's  bookkeep- 
ing." Such  figures  have  to  do  with  the  life  history  of  na- 
tional populations.  They  point  out  the  causes  of  death,  the 
increases  and  decreases  in  mortality;  and,  of  course,  indirectly 
these  statistics  of  health  and  disease  suggest  the  organization 
of  such  sanitary  and  hygienic  corrective  measures  as  would 
more  or  less  successfully  counteract  those  causes  of  disease 
and  degeneracy  which  are  contributory  to  any  given  mortal- 
ity rate. 

Vital  statistics  must  be  interpreted  by  experts.  A  great 
many  factors  enter  into  their  correct  understanding,  and  it 
is  sometimes  possible,  apparently,  to  prove  two  contradictory 
propositions  by  the  same  statistical  data.  The  questions  of 
race,  nationality,  season,  sex,  and  occupation,  not  to  mention 


32  RACE  DECADENCE 

locality,  all  enter  into  the  interpretation  of  these  figures 
regarding  health  and  disease.  For  instance,  women  are, 
in  general,  longer  lived  than  men ;  while  recently  settled  com- 
munities contain  more  young  people  in  the  prime  of  life,  and 
therefore  would,  necessarily,  show  a  lower  death-rate.  The 
large  cities  present  their  own  peculiar  problems  which  must 
be  taken  into  consideration  in  the  study  of  vital  statistics. 

Owing  to  the  fact  that  vital  statistics  are  a  function  of  the 
state,  and  are  not  kept  or  collected  by  the  federal  govern- 
ment, we  have  no  complete  body  of  figures  covering  the 
whole  of  the  United  States.  From  time  to  time  new  cities 
are  added  to  the  registration  area  of  the  country,  so  that  up 
to  the  present  time  we  have  twenty-seven  states,  the  District 
of  Columbia,  and  forty-three  cities  in  non-registration  states, 
embraced  in  the  vital  statistics  registration  area  of  the  coun- 
try. This  comprises  about  75  per  cent  of  the  population,  so 
that  by  estimating  the  25  per  cent  in  the  non-registration 
area,  we  are  able  to  arrive  at  something  approximating  cor- 
rectness, in  the  mortality  estimates  for  the  nation  as  a  whole. 

BIRTH-RATES  AND  DEATH-RATES 

The  birth-rates  of  most  civilized  countries,  like  the  mar- 
riage-rates, have  been  on  a  steady  decline  for  a  number  of 
years.  It  seems  that  the  civilized  peoples  are  getting  married 
at  a  later  age,  as  the  years  go  by,  thus  reducing  the  length  of 
the  period  of  reproduction;  but  we  think  the  birth-rate  is 
more  directly  influenced  by  other  causes,  such  as  the  more 
widespread  practice  of  various  methods  of  "  birth  control " 
and  by  the  economic  situation  —  the  High  Cost  of  Living. 
The  rapidly  declining  birth-rate  among  the  French  people  is 
a  cause  for  alarm,  not  only  to  that  nation,  but  to  other  civilized 
peoples.  A  hundred  years  ago  France  represented  25  per 
cent  of  the  population  of  the  so-called  Great  Powers  of  the 
world.  Today  it  represents  12  per  cent,  and  this  great  decline 


POSTPONING  YOUR  FUNERAL         33 

is  almost  entirely  due  to  the  falling  off  of  the  birth-rate. 
The  same  thing  is  happening  in  England,  and  in  the  United 
States,  the  increasing  decline  of  the  birth-rate  is  found  among 
the  descendants  of  the  original  colonists  and  the  earlier 
immigrants. 

A  hundred  years  ago  our  forefathers  frequently  had  fam- 
ilies numbering  a  dozen  or  more  children.  Nowadays  a 
family  of  six  or  eight  is  sufficiently  large  to  attract  general 
attention.1  The  large  families,  today,  in  the  United  States, 
are  to  be  found,  most  frequently,  among  the  more  recent 
immigrants.  Now,  if  the  death-rate  increases,  or  is  not  de- 
creased, in  the  presence  of  this  declining  birth-rate,  we  have 
a  serious  problem  confronting  us,  from  the  standpoint  of  nor- 
mal growth  and  the  future  of  the  race.  - 

t  THE  DEATH-RATE 

The  mortality  rate  for  the  last  year-  for  which  we  have 
complete  reports  was  14.2  per  1,000  of  population.  This  is  a 
trifle  higher  than  in  the  past  five  years ;  in  fact  the  highest 
since  1911,  when  it  was  the  same  rate.  This  means  that 
every  American  born  has  an  average  chance  of  living  to  be  70 
years  old.  That  is,  that  would  be  the  apparent  or  statistical 
length  of  life;  but,  as  we  shall  see  presently,  it  is  not  in 
reality  the  true»average  length  of  life.  If  the  death-rate 
should  ever  fall  as  low  as  10  per  1,000  —  as  it  might  conceiv- 
ably in  some  communities  —  and  should  continue  at  that  point 
for  a  long  period,  it  would  mean  that  the  inhabitants  would 
average  100  years  of  age  at  death.  A  stationary  mortality 
rate  of  12  would  mean  an  average  age  of  83,  while  one  at 
15  would  mean  an  average  of  nearly  67  years. 

The  influence  of  age  on  the  mortality  statistics  is  the  most 
disturbing  factor.  For  example,  the  mortality  rate  per  1,000 


1  The  last  census  report  states    that  the   average    family   in   the 
United  States  consists  of  4.3  persons. 


34  RACE  DECADENCE 

children  under  5  years  of  age  is  about  ten  times  that  of  per- 
sons between  5  and  25,  and  more  than  six  times  that  of  adults 
between  25  and  45.  It  is,  therefore,  apparent  that  the 
greater  proportion  of  very  young  and  very  old  to  be  found 
in  any  population  materially  increases  the  death-rate.  It 
should  also  be  remembered  that  we  have  about  10,000  suicides 
a  year. 

In  Appendix  A,  Table  No.  i,  will  be  found  a  table  show- 
ing the  death-rates  in  this  country  from  1907  to  1917. 

RACE  AND  MORTALITY 

Racial  peculiarities  and  national  tendencies  have  a  direct 
influence,  not  only  on  health  and  vitality,  but  upon  the  death- 
rate.  For  instance,  the  Negro  race  is  much  more  subject  to 
certain  diseases  than  are  the  white  peoples  ;  and,  due  to  lower 
standards  of  hygienic  living,  wherever  the  Negro  population 
predominates  in  the  United  States,  there  invariably  appears 
a  higher  death-rate,  all  things  being  equal.  In  fact,  it  really 
becomes  necessary  completely  to  separate  mortality  tables 
for  the  white  and  black  races,  in  order  to  arrive  at  a  true 
understanding  of  the  situation. 

In  some  cities  the  death-rate  of  Negro  babies  and  young 
children  of  certain  ages  is  just  double  that  of  the  white  chil- 
dren in  the  same  localities.  Of  course  some  of  this  infant 
mortality,  in  both  whites  and  blacks,  is  due  to  the  overcrowded 
condition  of  the  slums  of  our  large  cities,  where  poverty, 
immorality,  ignorance,  and  insanitary  habitations,  together 
with  a  high  birth-rate,  carelessness  and  filth,  contribute  enor- 
mously to  increase  the  death-rate. 

CITY  AND  RURAL  DEATH-RATE 

Some  interesting  information  can  be  gleaned  from  study- 
ing and  comparing  the  city  and  rural  death-rates  of  the  origi- 
nal registration  states. 


POSTPONING  YOUR  FUNERAL  35 

Annual  death-rate  per  1,000  living  white  males: 

Age  Rural  Cities  Excess  Per  Cent,  City 

20-24  4.83  4-93                           2 

25-29  5-13  573                          II 

30-34  5-39  7-32                         34 

35-39  6.30  9.73                          54 

40-44  7.06  12.  IO  71 

45-49  8.67  15-18  75 

50-55  10.65  19.17  80 

We  learn  by  these  tables  that  the  mortality  in  the  cities; 
especially  at  the  middle  ages  of  life,  greatly  exceeds  that  in 
the  rural  districts.  There  is  a  warning  in  these  figures  which 
we  should  heed.  It  is  not  alone  that  we  need  to  cultivate 
more  land  and  raise  more  food,  but  we  need  to  place  more 
people  on  the  land  and  so  to  govern  and  guard  the  health  of 
o^ir  industrial  classes  in  the  cities  that  its  limited  call  on 
muscular  activities  and  greater  strain  on  vital  organs  may  be, 
to  some  extent,  neutralized. 

The  population,  taken  as  a  whole,  might  not  show  such  a 
balance  in  favor  of  the  country.  In  some  respects  the  city 
is  a  more  healthy  place  than  the  country.  Modern  sanitation, 
and  other  measures  which  safeguard  the  health  of  the  chil- 
dren in  the  larger  cities,  are,  year  by  year,  contributing  to 
make  the  children  of  the  cities  more  healthy  and  vigorous 
than  the  famed  "  healthy  country  boy." 

PRINCIPAL  CAUSES  OF  DEATH  IN  THE  UNITED  STATES 

The  last  report  of  the  Census  Bureau  on  the  principal 
causes  of  death  in  the  United  States,  is  highly  instructive, 
and  it  represents  our  national  system  of  bookkeeping  as 
regards  disease  and  mortality.  The  latest  report  we  have  at 
hand  represents  a  general  death-rate  of  14.2  per  1,000  of 
population.  (See  Fig.  4.) 

Of  the  total  number  of  deaths  occurring  in  the  United 
States,  almost  one-third  are  due  to  three  disorders  —  heart 


36  RACE  DECADENCE 

disease,  pneumonia,  and  tuberculosis ;  while  the  next  one-third 
of  deaths  are  due  to  the  following  nine  causes:  Bright's 
disease,  or  nephritis,  apoplexy,  cancer,  diarrhea,  or  enteritis, 
arterial  diseases,  influenza,  diabetes,  diphtheria,  and  bron- 
chitis. And  it  may  be  of  interest,  in  this  connection,  to  repeat 
that  only  twenty-eight  states  (including  the  District  of 
Columbia)  keep  vital  statistics — 'only  twenty-eight  states 
keep  books  respecting  health,  disease,  and  death. 

Heart  disorders. —  During  this  one  year  there  were  115,337 
deaths  (153.2  per  100,000)  from  organic  diseases  of  the 
heart,  including  endocarditis,  and  this  is  a  little  better 
showing  than  was  made  in  some  years  previous.  While  statis- 
tics on  heart  disease  fluctuate  from  year  to  year,  there  has 
been  a  general  and  steady  increase,  even  a  marked  increase 
since  1900,  the  first  year  in  which  these  annuaj  mortality 
statistics  were  published,  and  which  showed  a  rate  of  only 
123.1  per  100,000  as  the  mortality  rate  for  heart  disorders. 

Pneumonia  —  including  bronchial  pneumonia,  was  respon- 
sible for  112,821  deaths  (149.8  per  100,000  of  population), 
and  represents  one  of  the  highest  rates  noted  for  several 
years.  The  pneumonia  death-rate  has  been  coming  up  stead- 
ily for  several  years. 

Tuberculosis  —  in  its  various  forms,  was  responsible  for 
1 10,285  deaths,  of  which  97,047  were  due  to  tuberculosis  of 
the  lungs.  The  death-rate  from  all  forms  is  146.4  per  100,000 
of  population.  The  death-rate  from  tuberculosis  has  been 
declining  gradually  ever  since  1904,  having  decreased  nearly 
30  per  cent.  Until  1912  more  deaths  were  due  to  tuberculosis 
than  to  any  other  single  cause,  in  America,  but  during  that 
year  it  gave  way,  allowing  heart  disease  to  occupy  first  place. 

Bright's  disease. —  Diseases  of  the  kidneys  caused  80,912 
deaths  (107.4  per  100,000  of  population).  Kidney  disorders 
have  increased  almost  continually  for  twenty  years,  the 
death-rate  being  only  89  per  100,000  in  1900. 


ACCIDENTS 


ALCOHOLISM 


ANEMIA 


APOPLEXY 


APPENDICITIS 


ARTERIAL  DIS. 


BRONCHITIS 


CANCER 


CONGENITAL 


DIABETES 


DIPHTHERIA 


ERYSIPELAS 


HEART  DIS. 


HERNIA 


INFLUENZA 


INTESTINAL 


KIDNEY  DIS. 


LEUKEMIA 


LIVER  DIS. 


MALARIA 


I 


MEASLES 


MENINGITIS 


PELLAGRA 


PNEUMONIA 


POLIOMYELITIS 


PUERPERAL 


RESPIRATORY 


RHEUMATISM 


RICKETS 


SCARLET  FEVER 


SCURVY 


STOMACH 


TUBERCULOSIS 


TYPHOID  FEVER 


UNDEFINED 
VENEREAL 


ALL  OTHER  DISEASES 


.38  RACE  DECADENCE 

Apoplexy  and  paralysis  —  were  the  cause  of  62,431  deaths 
(82.9  per  100,000),  and  this  rate  has  increased  almost  con- 
tinually for  twenty  years. 

Cancer  —  and  other  malignant  tumors  caused  61,452 
deaths.  The  rate  for  cancer  death  has  risen  from  63  per 
100,000  in  1900  to  81.6  in  1917.  Of  these  cancer  deaths,  38 
per  cent  were  due  to  cancer  of  the  stomach  and  liver,  and 
of  course,  some  at  least  of  this  increased  death-rate  for  cancer 
must  be  attributed  to  more  care  and  efficiency,  in  making  the 
diagnosis,  on  the  part  of  the  medical  profession. 

Diarrhea  —  and  enteritis  caused  59,504  deaths  (79  per 
100,000) .  This  group  of  diseases  represents  a  falling  death- 
rate  in  recent  years,  and  it  should  be  borne  in  mind  that 
more  than  four-fifths  of  the  total  deaths  charged  to  this 
cause  occurred  in  infants  under  2  years  of  age. 

Arterial  disorders  —  of  various  sorts,  aneurism,  hardening 
of  the  arteries,  etc.,  resulted  directly  in  19,055  deaths  (25.3 
per  100,000).  The  increase  in  these  disorders  has  been 
continual  from  1900,  when  it  was  only  6.1  per  100,000. 

Influenza  —  was  responsible  for  12,974  (17.2  per  100,000), 
and  represents  a  death-rate  lower  than  the  preceding  year 
and  of  course  much  lower  than  some  of  the  years  that  have 
succeeded. 

Diabetes. —  Deaths  due  to  this  disease  numbered  12,750 
(16.9  per  100,000).  The  death-rate  from  this  disease  has 
risen  almost  continually  from  1900,  when  it  was  9.7. 

Other  causes  of  death.  —  During  the  year  there  were 
6,724  (8.9  per  100,000)  deaths  from  automobile  accidents 
alone.  Accidental  drowning  caused  5,550  deaths  (7.4  per 
100,000).  From  asphyxiation  we  had  3,375  deaths  (4.5 
per  100,000).  Mine  accidents  caused  2,623  deaths  (3.5  per 
100,000).  Deaths  from  vehicles  other  than  railroad  cars 
and  automobiles  numbered  2,326;  street-car  accidents, 
2,227;  machinery  accidents,  2,212;  hot  weather,  1,964;  while 


POSTPONING  YOUR  FUNERAL  \          39 

the  number  of  suicides  reported  for  1917  was  10,056  or 
13.4  per  100,000. 

Other  deaths  due  to  external  causes,  including  homicides, 
total  18,353  or  244  Per  100,000. 

The  complete  table  showing  the  death-rate  from  various 
diseases,  the  rate  per  100,000  of  population,  etc.,  may  be 
found  in  Appendix  A,  Table  No.  2. 

AVERAGE   LENGTH    OF  LIFE 

It  is  true  that,  during  the  last  hundred  years,  the  average 
length  of  life  has  apparently  increased  from  thirty-three 
years  up  to  about  forty,  and  can  be  variously  figured  out, 
by  different  methods  and  in  different  countries,  as  extend- 
ing up  to  forty-five  or  even  fifty  years  and  more,  at  the 
present  time.  Now,  some  of  our  enthusiastic  sanitarians 
point  with  pride  to  this  achievement,  and  attribute  it  to  the 
improved  sanitation  in  our  great  cities.  They  claim  that  our 
sewerage  systems,  pure  water  supply,  better  milk,  etc.,  have 
all  contributed  to  this  decrease  in  mortality. 

On  the  surface,  it  does  seem  that  the  increase  of  the 
length  of  life  has  just  about  kept  pace  with  improvement  in 
sanitation  and  public  health  measures,  but  when  we  begin 
to  analyze  the  statistics  we  discover  that  this  apparent  in- 
crease in  the  average  length  of  life  is  almost  wholly  the 
result  of  lessening  the  death-rate,  on  the  one  hand,  from  such 
contagious  diseases  as  typhoid,  smallpox,  cholera,  plague, 
etc. ;  while,  on  the  other,  it  results  from  increasing  the  num- 
ber of  years  which  are  lived  by  the  population  on  the  two 
extremes  of  life  —  that  is  increasing  the  length  of  life  of 
infants  and  of  the  very  aged,  and  other  weak  and  enfeebled 
members  of  society.  We  do  not  allow  the  children  of  the 
poor,  or  the  insane  and  feeble-minded,  to  die  as  early  as  we 
used  to.  Science  has  intervened  and  reversed  the  law  of 
the  jungle.  Nature  has  decreed  the  survival  of  the  fittest, 


40  RACE  DECADENCE 

but  civilization  has,  these  last  few  years,  ordained  also  the 
survival  of  the  unfit,  both  among  the  very  young  and  the 
very  old. 

The  true  standard  of  vital  endurance  is  not  this  apparent 
statistical  average  length  of  life,  but  rather  the  number  of 
persons  per  thousand  in  the  population  who  attain  great 
age.  As  years  go  by,  in  any  community,  in  any  city,  or 
in  any  state,  there  will  be  found  a  lessened  number  of  cen- 
tenarians, and  so,  while  it  is  true  that  the  average  length  of 
life  has  been  increased,  it  is  also  equally  true  that  the 
chance  of  any  one  individual  living  to  a  good  old  age  has 
been  markedly  decreased.  In  other  words,  we  have  in- 
creased the  average  length  of  life  by  adding  to  the  longevity 
of  the  infant,  the  weak  and  feeble,  and  certain  groups  of 
aged  persons,  rather  than  by  adding  to  the  length  of  life 
of  the  strong  and  robust  —  in  fact,  as  will  be  subsequently 
shown,  in  some  respects  this  desirable  group  in  our  popula- 
tion is  not  living  quite  as  long  as  it  used  to. 

What  is  the  average  length  of  life  today?  That  is  a 
difficult  question  to  answer.  There  are  several  methods  of 
figuring  out  an  answer  to  this  question  such  as  the  average 
age  at  death,  found  by  dividing  the  combined  ages  of  all 
those  dying  in  the  registration  area  in  a  given  year,  by  the 
number  dying,  say  39.8.  These  figures  are,  however,  of 
little  value  because  they  do  not  relate  to  a  stationary  popula- 
tion. Moreover,  you  cannot  determine  the  average  length  of 
life  by  dividing  1,000  by  the  death-rate,  because  the  death- 
rate  refers  to  a  constantly  changing  population,  due  both  to 
the  excess  of  births  over  deaths  and  also  to  immigration. 

The  expectancy  of  life  given  in  the  Life  Tables  is  prob- 
ably the  most  reliable  figure,  because  it  is  based  on  a 
stationary  population  and  on  mortality  data  of  several  years. 
These  tables,  however,  do  not  relate  to  the  entire  United 
States.  As  you  will  see  in  these  tables,  the  expectancy  of 


POSTPONING  YOUR  FUNERAL  41 

life  for  both  sexes  taken  together  is  51.49  in  the  original 
registration  states,  while  many  other  figures  are  given  —  for 
males  alone,  females  alone,  white  males,  white  females,  etc. 
By  referring  to  the  Life  Expectancy  Tables,  Appendix  A, 
Table  No.  3,  you  will  be  able  to  ascertain  the  number  of 
years  an  individual  of  any  given  age  may  (on  the  average) 
expect  to  live. 

WHEN   WILL  YOU  DIE? 

The  life  insurance  companies  employ  men  to  figure  out 
when  you  will  die  —  when  the  average  American  citizen  is 
due  to  pass  on.  They  do  this  in  order  to  find  out  what  they 
must  charge  for  life  insurance.  The  actuary  of  the  Equitable 
Life  Assurance  Society  of  the  United  States  recently  dis- 
cussed this  subject  before  a  meeting  of  life  insurance  pres- 
idents, and  someone  made  the  following  digest  of  his 
remarks : 

It  is  the  business  of  a  life  insurance  actuary  to  figure  when 
you  will  die.  He  keeps  an  eye  on  you  all  the  time.  Not 
you,  personally,  but  you  as  an  average  American.  You  look 
smooth,  pink,  and  healthy.  You  are  a  good  liver.  (He 
said  are  not  have.) 

The  medium  age  at  death  of  the  American  people  is 
about  43  years.  Your  eyes  have  been  strained  by  inside 
work  —  hence  the  glasses.  Your  teeth  look  good,  but  they 
need  attention. 

You  are  seriously  overstraining  heart,  arteries,  kidneys, 
nerves,  and  digestion  —  as  the  rapidly  increasing  death-rate 
shows.  You  are  always  in  a  hurry.  You  could  detect  and 
head  off  these  troubles  if  you  would  go  to  a  doctor  for  an 
occasional  examination. 

Under  exertion  you  are  short-winded,  due  to  lack  of 
exercise  or  a  bad  heart.  Your  four  hundred  muscles  are 
virtually  all  soft  and  weak  from  lack  of  use.  You  are 


42  RACE  DECADENCE 

designed  as  an  erect,  outdoor  animal,  with  feet  and  legs  for 
service;  but  you  lie  down  all  night  and  sit  down  all  day. 
You  never  walk  when  you  can  ride.  The  arches  of  your 
feet  are  gradually  falling,  because  the  muscles  provided  to 
hold  them  up  have  weakened  from  long  disuse. 

Your  ancestors  lived  on  a  farm;  the  proportion  of  people 
living  in  cities  has  increased  131  per  cent  in  fifty  years. 

You  feed  your  stomach  with  all  sorts  of  tasty  junk,  much 
of  which  cannot  be  fully  digested;  so  you  develop  auto- 
intoxication. 

With  every  pound  of  fat  you  gain,  your  chances  of  a 
shortened  life  increase.  You  eat  30  per  cent  more  food  than 
your  grandfather  did;  and  374  per  cent  more  sugar. 

You  have  been  drinking  19.8  gallons  of  liquor :  he  drank 
6.4.  You  do  this  in  spite  of  the  repeated  warning  of  insur- 
ance companies  that  moderate  drinkers  die  18  per  cent  faster 
than  total  abstainers ;  and  steady  drinkers  86  per  cent  faster. 

You  spend  367  per  cent  more  for  patent  medicines  and 
drugs  than  your  father  did ;  and  you  drink  54  per  cent  more 
coffee. 

In  your  easy-going,  optimistic  way,  you  are  cheered  by 
the  fact  that  the  general  death-rate  seems  to  be  declining. 
You  fool  yourself  with  the  notion  that  this  means  a  good 
old  age  for  you.  As  a  matter  of  fact,  the  decrease  in  the 
death-rate  is  due  to  the  better  care  of  infants  and  certain 
classes  of  old  folks.  Not  only  is  the  adult  death-rate  not 
decreasing;  it  is  alarmingly  increasing. 

Since  1900  the  death-rate  from  Bright's  disease  has  in- 
creased 15  per  cent;  from  diseases  of  the  heart  27  per  cent. 
These  are  the  diseases  of  adult  life,  the  diseases  of  hurry  and 
worry  and  overeating  and  nervous  wear  and  tear. 

Remember,  this  is  the  picture  of  a  life  insurance  official, 
whose  business  it  is  to  figure  how  much  you  ought  to  pay 


POSTPONING  YOUR  FUNERAL         43 

for  life  insurance,  in  view  of  the  fact  that  you  will  probably 
die  before  you  are  50  years  old. 

But  there  is  hope  for  you.  An  annual  medical  examina- 
tion, more  exercise  outdoors,  less  food,  more  dentistry,  no 
booze,  more  walking,  and  less  taxicabs.  Most  of  all  —  no 
hurry  and  no  worry. 

WHY  PERIODICALLY  INSPECT  YOUR  CAR  AND 
NEGLECT  YOURSELF? 

The  one  prominent  characteristic  of  our  present-day 
social  and  commercial  life  is  its  high  tension.  People  are 
living  at  a  fierce  pace,  and  the  pressure  gauge  of  life  reg- 
isters all  the  while  dangerously  near  the  bursting-point. 
Just  as  the  smoke  of  the  hot  box  warns  the  trainmen  of 
approaching  danger,  so  high  blood-pressure  sounds  its  warn- 
ing note  of  impending  disaster.  No  automobilist  would 
dare  heedlessly  to  drive  his  machine  with  a  shrieking  axle 
or  a  rattling  wheel  unless  his  journey  were  actually  one 
of  life  and  death;  and  yet  how  often  we  observe  men  and 
women  forcing  their  body  machines  forward  under  the  lash 
of  ambition  —  utterly  heedless  of  the  disease  danger  signals 
which  loom  up  in  the  pathway  of  life  —  just  ahead. 

The  higher  the  speed  —  the  more  intensely  you  drive 
the  human  machine  —  the  more  the  necessity  that  the  bodily 
mechanism  be  regularly  inspected.  You  think  nothing  of 
spending  from  twenty-five  to  one  hundred  dollars,  periodi- 
cally, for  having  your  automobile  overhauled  and  kept  in 
first-class  running  order;  why  not  be  willing  to  invest  a 
reasonable  amount  of  money  and  devote  a  little  of  your, 
time  to  the  all-important  work  of  the  periodical  inspection 
and  the  annual  overhauling  of  your  physical  body  —  your 
nervous,  digestive,  circulatory,  and  eliminative  mechanisms? 

An  alert,  active  brain,  readily  grasping  the  intricate  prob- 
lems of  twentieth-century  business,  isn't  found  in  a  run- 


44  RACE  DECADENCE 

down  body.  Prevent  physical  ailments  and  you  can  the 
better  maintain  the  mental  and  bodily  mechanisms  at  top- 
notch  efficiency. 

THE  MODERN   HEALTH  AUDIT 

After  one  reaches  the  age  of  twenty-five  he  should  sub- 
mit himself  to  a  searching  "  health  audit "  every  five  years. 
This  investigation  should  be  repeated,  with  a  less  complete 
annual  research  during  the  intervening  years  —  a  check-up 
of  urine,  blood-pressure,  teeth,  etc. 

Bright's  disease,  apoplexy,  heart  failure,  nervous  prostra- 
tion, diabetes,  and  many  other  physical  and  nervous  dis- 
orders, which  contribute  so  largely  to  the  death-rate  and 
the  crippled  efficiency  of  the  civilized  races,  usually  cast 
their  warning  shadows  a  long  way  ahead  of  the  actual  cata- 
clysm. They  hang  out  red  lanterns  of  forewarning  which 
could  not  be  overlooked  by  these  systematic  and  periodic 
physical  audits  and  medical  examinations. 

There  are  two  reasons  why  every  successful  business  and 
professional  man  has  not  been  "audited:"  first,  he  has 
not  appreciated  its  importance;  second,  there  has  been  no 
adequate  provision  made  for  this  service. 

But  times  are  changing.  Today  intelligent  men  of  affairs 
are  coming  to  appreciate  the  vital  importance  of  knowing 
just  where  they  stand  in  physical  efficiency  —  just  what  is 
their  balance  in  the  ledger  of  life.  And  this  is  being  driven 
home  by  the  attitude  of  some  of  our  bankers  and  insurance 
companies,  who  are  beginning  to  demand  physical  audits^ 
showing  a  clean  bill  of  health  from  men  to  whom  they  make 
commercial  loans.  The  time  is  not  far  distant  when  any 
man  who  secures  a  loan  in  which  the  personal  equation 
figures  at  all,  will  be  compelled  to  submit  to  his  banker  a 
"  physical  auditor's  report "  as  a  part  of  his  assets. 

Why  are  hundreds  of  thousands  of  dollars  spent  every 


POSTPONING  YOUR  FUNERAL  45 

year  to  determine  how  the  bookkeepers,  cashiers,  and  account- 
ants of  this  country  are  doing  their  work  and  next  to 
nothing  to  find  out  how  the  vital  organs  —  the  lungs,  liver, 
kidneys,  heart,  and  blood  vessels  —  of  the  men  who  employ 
these  same  bookkeepers  are  doing  theirs? 

You  can  fire  an  incompetent  accountant  and  hire  a  good 
one,  but  not  so  with  your  vital  organs ;  when  they  go  "  stale  " 
it's  too  late  to  "  lock  the  barn ;"  better  to  have  watched  the 
door  and  caught  the  thief. 

What  would  you  think  of  an  engineer  who  never  inspected 
his  machinery  until  notified  of  a  breakdown?  What  would 
you  think  of  a  business  man  who  never  audited  his  books 
until  informed  that  his  cashier  had  absconded?  What  do' 
you  think  of  the  nation  that  fails  to  prepare  against  war 
untS  hostilities  break  out  ?  And  last,  but  by  no  means  least, 
what  do  you  think  of  men  and  women  who  never  have  their 
bodily  machines  inspected  until  a  physical  breakdown  or 
nervous  "  blow-up  "  makes  action  imperative  ? 

Of  course,  we  must  all  pass  on  some  time,  but  why,  by 
neglecting  reasonable  means  of  prevention,  should  we  hasten 
that  event?  Every  thinking  man  should  be  interested  in 
the  possibility  of  postponing  his  own  funeral. 

A  table  showing  death-rates  at  different  ages  will  be 
found  in  Appendix  A,  Table  No.  4. 

LONGEVITY  IN  THE  UNITED  STATES 

The  expectation  of  life  or,  better,  the  average  duration  of 
life  at  various  ages  and  in  different  racial  groups,  has  been 
a  common  theme  of  statistical  inquiry.  Improved  and  more 
exact  methods  of  calculation,  together  with  the  accumula- 
tion of  additional  data,  are,  however,  continually  stimulating 
fresh  studies  in  this  field.  A  recent  article  by  Forsyth  on 
the  trend  of  longevity  in  the  United  States,  although  it  deals 
only  with  the  census  records  from  1890  to  1910,  contains 


46  RACE  DECADENCE 

some  important  figures.  In  1890  the  expectation  of  life  for 
a  male  native  white  of  native  parentage  at  10  years  of  age 
was  56.1;  by  1910  this  had  fallen  to  54.1.  At  the  age  of. 
40  the  expectation  in  1890  was  32.8;  in  1910,  only  29.9. 
In  fact,  in  each  age  group  and  in  both  sexes  the  average 
expectation  showed  a  notable  loss  for  the  two  decades  from 
1890  to  1910.  A  large  loss  in  expectation  was  also  shown 
by  the  native  whites  of  foreign  and  mixed  parentage.  On 
the  other  hand,  the  foreign-born  whites,  especially  the  males, 
gained  materially  in  the  average  duration  of  life  during  the 
same  period.  Forsyth  emphasizes  especially  two  points: 
first,  the  remarkable  longevity  enjoyed  by  native  Americans 
of  native  parentage,  which  he  considers  probably  unequaled 
anywhere  else  on  earth;  and  second,  the  gradual  loss  of 
this  superiority  at  a  rate  of  about  one  year  each  decade. 
He  seems  inclined'  to  attribute  this  "  momentous  retrogres- 
sion "  to  certain  unspecified  "  factors  in  the  American  mode 
of  living ;  "  but  it  seems  evident  that  the  conditions  are 
very  complex.  He  observes: 

The  native  whites  of  native  parentage  are  being  added  to  all  the 
time  from  various  racial  stocks  not  perhaps  as  resistant  as  the 
original  native  stocks.  From  decade  to  decade  therefore,  the  native 
whites  of  native  parentage  represent  an  ethnically  different  group. 
Whether  the  loss  in  expectation  is  due  to  some  mingling  of  less 
resistant  strains  or  whether  the  shortening  in  average  duration  of 
life  is  due  to  purely  environmental  factors,  can  perhaps  hardly  be 
determined.  The  question  is  one  that  must  be  considered  in  con- 
nection with  the  fact  that  in  recent  years,  in  this  country,  the  gen- 
eral mortality  has  increased  disproportionately  in  the  ages  above  40. 
At  all  events,  the  bearing  of  the  census  of  1920  on  the  trend  of 
longevity  will  be  awaited  with  interest. 

SUMMARY   OF  THE   CHAPTER 

I.  The  time  has  come  when  the  American  citizen  should 
wake  up  and  take  a  real  interest  in  postponing  his  own 
funeral. 


POSTPONING  YOUR  FUNERAL  47 

2.  Vital  statistics  are  "  humanity's  bookkeeping."     They 
form  the  basis  of  all  health  movements,  and  should  be  inter- 
preted by  experts. 

3.  In  the  United  States  the  registration  area  for  the  col- 
lection of  vital  statistics  represents  only  about  75  per  cent 
of  the  population. 

4.  Both  the  birth-rates  and  marriage-rates  of  the  civilized 
nations  have  been  on  a  steady  decline  for  many  years. 

5.  In  this  country  there  is  an  increasing  decline  in  the 
birth-rate  among  the  descendants  of  the  original  colonists. 

6.  In    America,    today,   the   largest    families   are   to   be 
found  among  the  most  recent  immigrants. 

7.  Since  our  death-rate  is  about  15  per  1,000  it  gives  us  a 
"  statistical "  length  of  life  of  70  years.     But  we  do  not 
actually  average  that. 

8.  The  deaths  among  the  very  young  and  the  very  old 
greatly  disturb  the  mortality  statistics,  and  we  have  10,000 
suicides  annually. 

9.  Race  directly  affects  the  death-rate.     The   Negro  is 
more  subject  to  numerous  diseases.    In  some  cities  twice  as 
many  Negro  children  die  as  white  children. 

10.  As  between  city  and  country  the  death-rate  for  those 
under  20  years  is  about  the  same ;  above  that  age  it  becomes 
increasingly  higher  in  the  cities. 

11.  In  some  respects  the  city  is  a  healthier  place  for  chil- 
dren than  the  country. 

12.  Almost  one-third  of  the  total  deaths  in  the  United 
States  are  due  to  three   disorders  —  heart   disease,   pneu- 
monia, and  tuberculosis. 

13.  The  next  one-third  of  deaths  are  due  to  nine  causes 
—  kidney  troubles,   apoplexy,   cancer,   intestinal   disorders, 
arterial  diseases,  influenza,  diabetes,  diphtheria,  and  bron- 
chitis. 

14.  One  hundred  and  fifty-three  persons  out  of  every 
1,000  die  of  heart  diseases  each  year  in  this  country. 

15.  One  hundred  and  fifty  persons  out  of  every  1,000  die 
of  pneumonia  annually;  and  107  out  of  every  1,000  perish 
of  Bright's  disease. 

16.  Apoplexy,  paralysis,  and  hard  arteries  claim  108  out 
of  every  1,000  each  year;  cancer  claims  81  per  100,000. 


48  RACE  DECADENCE 

17.  The  apparent  increase  in  the  average  length  of  life  is 
deceptive,  and  is  due  to  decreasing  the  plagues  and  lessening 
the  death-rate  of  the  very  young  and  very  old. 

18.  The  increase  in  life  is  due  to  a  reversal  of  the  law 
of  natural  selection.     We  are  increasingly  prolonging  the 
lives  of  the  unfit. 

19.  The  truer  standard  of  vital  resistance  is  the  number 
of  persons  per  1,000  who  attain  great  age. 

20.  There  are  many  ways  of  figuring  the  average  length 
of  life;  the  most  reliable  probably  being  that  of  the  Life 
Expectancy  Tables  —  which  gives  51.49  as  the  American 
average  for  both  men  and  women. 

21.  The  life  insurance  companies  figure  the  medium  age 
at  death  as  about  43  years,  and  they  estimate  that  this  can 
be  greatly  lengthened  by  proper  habits  of  living. 

22.  They  say  we  eat  30  per  cent  more  than  our  grand- 
parents, consume  374  per  cent  more  sugar,  and  drink  54 
per  cent  more  coffee. 

23.  In  twenty  years  the  death-rate  for  kidney  disorders 
has  increased  1 5  per  cent ;  for  heart  diseases  27  per  cent. 

24.  Why  should  you  periodically  inspect  your  machinery 
and  motors,  and  wholly  neglect  to  have  your  own  body 
overhauled  ? 

25.  Most  all  serious  physical  disorders  cast  their  warning 
shadows  beforehand,  and  would  be  detected  by  the  annual 
health  audit. 

26.  A  study  of  the  expectation  of  life  at  various  ages 
shows  a  distinct  decline  every  ten  years  in  the  census  returns 
for  recent  periods,  that  is,  among  the  native  white  popula- 
tion of  the  United  States. 


CHAPTER  IV 
SICKNESS  IN  THE  UNITED  STATES 

IT  IS  not  generally  appreciated  that  a  great  deal  of  our 
minor  and  commonplace  sickness  is  largely  preventable; 
while  other  varieties  of  affliction  are  due  to  inherent  weak- 
nesses in  the  stock.  We  experience  a  tremendous  economic 
loss  every  year  in  the  United  States  as  a  result  of  this 
vast  toll  of  sickness  disability.  A  study  of  this  question 
as  itt  affects  the  American  people  discloses  at  once  that  we 
are  subject  to  attack  on  the  part  of  numerous  acute  and 
chronic  diseases,  against  which  we  possess  but  partial  means 
of  defense,  either  natural  or  as  regards  approved  scientific 
methods  of  disease  prevention. 

NEED  OF  A   HEALTH    REVIVAL 

Health  is  our  greatest  national  resource.  It  is  the  basis, 
not  only  of  all  efficiency,  but  also  of  human  happiness. 

The  American  people  are  only  half-hearfed  in  their  health 
wooing.  They  do  not  enter  into  the  conservation  of  health 
and  prevention  of  disease  with  the  same  enthusiasm  and 
whole-heartedness  that  characterizes  our  individual  business 
and  commercial  life. 

We  are  engaged  largely  in  treating  symptoms  rather 
than  fighting  disease  —  in  dealing  with  the  results  of  ill 
health,  rather  than  the  prevention  of  physical  disorders. 
We  are  undertaking  to  dam  the  stream  at  the  mouth  rather 
than  to  control  the  flow  of  disease  at  its  source. 

Health  is  worth  the  cultivation  from  the  standpoint  of 

49 


50  RACE  DECADENCE 

efficiency  alone.  It  constitutes  the  foundation  of  intellectual 
advancement,  while  it  is  also  the  veritable  background  for 
artistic  attainment  and  spiritual  enjoyment. 

Ill  health  with  its  resultant  incapacity  and  maladjustment 
of  home  life  is,  except  in  the  case  of  disturbed  sex  relations, 
in  my  opinion,  just  about  equal  to  all  other  causes  of  domestic 
unhappiness  and  subsequent  divorce. 

Sometimes  the  home  is  destroyed  by  that  type  of  ill  health 
which  manifests  itself  as  nervous  nagging,  carping  criticism, 
habitual  haranguing,  and  constant  complaining. 

Many  a  home  that  has  proved  invulnerable  to  drink  has 
been  wiped  out  by  drudgery  —  that  slavery  which  is  half 
poverty  and  half  disease,  and  which  never  fails  effectually 
to  destroy  human  happiness  and  the  joy  of  living. 

What  an  interesting  statistical  study  it  would  be  to  know 
how  many  bankruptcies  and  other  practical  business  failures 
each  year  are  due  to  failing  health,  insidious  disease,  and 
other  physical  and  mental  and  nervous  conditions  which 
could  have  been  easily  detected  and  largely  prevented  by 
regular,  periodic  "  health  audits  "  —  thoroughgoing  medical 
examination  before  the  individual  got  sick  or  either  broke 
down  or  "  blew  up." 

Heredity  is  to  blame  for  a  lot  of  inefficiency,  nervous 
wrecks,  and  failures,  just  as  much  as  it  is  for  insanity, 
epilepsy,  and  f eeble-mindedness ;  but  lack  of  training  and 
discipline  in  the  nursery,  together  with  subsequent  loss  of 
health  are  also  to  blame  for  many  criminals,  hysterics,  and 
other  erratic  and  unsocial  human  beings. 

Think  of  the  inefficiency  of  a  modern  government  when 
the  American  people  lose  almost  1,000,000  citizens  each  year 
from  premature  deaths  and  preventable  diseases. 

In  trying  to  bring  about  a  hygienic  revival  let  us  beware 
of  "health  fads."  Do  not  make  a  religion  out  of  hygiene. 
Avoid  fanatical  extremes  in  health  teaching.  Look  out  for 


SICKNESS  IN  THE  UNITED  STATES  51 

both  health  puritans  and  hygienic  nihilists  —  look  for  the 
"  golden  mean  "  in  health  practices  and  thus  avoid  injurious 
extremes. 

THE    SICKNESS    PROBLEM 

Is  there  a  real  sickness  problem  in  this  country  today 
which  requires  a  solution  and  which,  if  it  remains  unsolved, 
is,  and  will  be,  of  serious  detriment  to  the  health  of  the 
nation? 

There  have  been  a  number  of  sickness  surveys  made  by 
the  Metropolitan  Life  Insurance  Company  in  various  states 
of  the  Union,  covering  a  total  of  637,000  persons.  These 
surveys  cover  13,321  cases  of  illness.  Of  these,  12,114 
persons  were  so  disabled  as  to  prevent  them  from  following 
thejr  occupations.  Among  the  women  of  all  ages,  2.13  per 
cent  were  sick  and  1.93  per  cent  disabled.  Of  the  men,  2.05 
per  cent  were  sick  and  1.87  disabled. 

Of  the  376,573  people  over  15  years  of  age,  8,636  were 
disabled,  that  is,  2.3  per  cent.  The  average  loss  of  time 
through  sickness  for  each  person  of  working  age  was 
therefore,  8.4  days,  or  6.9  working  days  per  year. 

Separating  these  data  for  men  and  women  over  15  years, 
we  see  that  men  have  a  morbidity  rate  of  2.28  per  cent  and 
women  of  2.3  per  cent;  an  average  total  loss  by  days  of  8.3 
for  men  and  8.4  for  women.  These  are  for  the  white  race. 

The  California  commission  found  that  the  working  days 
lost  each  year  for  wage-earners  were  6  per  worker  in  that 
state.  The  Pennsylvania  Health  Insurance  Commission  has 
found  that  in  their  surveys  4.28  per  cent  of  the  population 
are  seriously  sick  at  all  times,  and  that  1.5  per  cent  of  the 
population  are  disabled  from  this  sickness  at  all  times.  The 
average  days  of  disability  per  year  for  all  persons  is  5.7, 
and  for  men  during  the  working  days  of  life  at  15  years 
and  over  is  8;  for  women  15  years  and  over  it  is  6.3, 


52  RACE  DECADENCE 

making  the  average  working  days  lost  per  year  6.6  for  men 
and  6.2  for  women. 

In  Ohio  the  Health  and  Old  Age  Insurance  Commission 
estimates  that  nearly  3  per  cent  of  the  people  were  sick  at 
all  times,  and  that  20  per  cent  of  the  workers  have  a  dis- 
abling sickness  lasting  over  7  days  each  year.  Each  worker 
loses  on  the  average  9  days  per  year  because  of  sickness. 

In  Connecticut,  in  the  case  of  certain  insurance  funds,  it 
was  found  that  each  worker  averaged  a  loss  of  6  working 
days  a  year. 

The  Illinois  commission,  in  studying  forty-one  blocks  in 
Chicago,  found  that  in  the  3,048  families,  containing  12,950 
persons,  65.8  per  cent  of  these  families  had  serious  illness 
in  them  during  the  year.  These  forty-one  blocks  were 
taken  in  that  part  of  the  city  which  was  representative  of 
the  various  wage-earning  groups  and  different  nationalities, 
and  every  family  in  each  block  was  canvassed. 

A  recent  sickness  survey  was  made  in  Philadelphia  by  the 
nurses  of  the  City  Department  of  Health.  This  study,  which 
covered  12,019  persons  in  seven  typical  industrial  districts 
in  Philadelphia,  revealed  514  cases  of  serious  illness,  making 
an  average  daily  sickness  rate  of  4.28  per  cent  of  the  popula- 
tion. Of  these  cases,  however,  only  36.7  per  cent  were 
"  unable  to  work,"  showing  that  an  average  of  1.57  per 
cent  of  the  persons  in  the  areas  visited  were  afflicted  each 
day  with  sickness  which  actually  disabled  them,  and  that 
each  person  suffered  approximately  5.7  days  of  disabling 
illness  each  year. 

Because  of  the  care  with  which  this  survey  was  made, 
and  the  close  agreement  between  its  results  and  those  of  the 
Metropolitan  Life  Insurance  Company's  study  of  cities  in 
western  Pennsylvania,  the  insurance  commission  considered 
it  a  fairly  accurate  measure  of  sickness  conditions  in  the 
state,  and  concluded  that  1.57  per  cent  of  the  population  is 


SICKNESS  IN  THE  UNITED  STATES  53 

constantly  suffering  from  disabling,  and  2.71  per  cent  more 
from  slighter  but  still  serious  illness ;  "  the  average  number 
of  days  of  disabling  sickness  of  adults  per  year  is  probably 
over  7,  and  the  average  number  of  days  lost  from  work  is 
about  6."  More  complete  investigations,  however,  would, 
in  the  author's  opinion,  show  higher  sickness  rates. 

The  assumption  that  among  wage-earners  the  average 
amount  of  sickness  equals  about  9  days  per  annum  is  based 
upon  European  data  of  doubtful  application  to  this  country. 
This  fact  was  brought  out  by  the  special  investigations  in 
California  showing  less  than  6  days  per  annum.  It  prob- 
ably depends  somewhat  upon  the  definition  adopted  and  as 
to  whether  or  not  prolongation  of  sickness  is  encouraged  by 
liberal  cash  payments  under  compulsory  health  insurance 
lawfc. 

THE  ROCHESTER  SICKNESS  SURVEY 

An  unemployment  survey  made  by  the  Metropolitan  Life 
Insurance  Company  in  conjunction  with  the  Bureau  of 
Labor  Statistics  of  the  federal  government,  during  1915,  and 
covering  over  a  million  wage-earners  in  selected  cities  of 
the  United  States,  developed  the  interesting  fact  that  n  per 
cent  of  the  unemployment  was  caused  by  sickness  or  acci- 
dent disability.  Over  I  per  cent  (1.2)  of  all  the  wage- 
earners  canvassed  were  unemployed  on  account  of  illness. 

In  the  Rochester,  New  York,  sickness  survey,  without 
qualification  of  age  period  or  extent  of  disability,  21.4 
males  and  24.8  females  out  of  each  1,000  living  were 
reported  sick.  Sicknesses  involving  incapacity  to  follow 
the  daily  pursuits  of  life  occurred  at  a  rate  of  17.8  per  1,000 
for  males  and  20.4  per  1,000  for  females.  If  we  eliminate - 
both  the  well  and  the  sick  under  ages  15  —  that  is,  children 
from  whom  it  was  more  difficult  to  obtain  a  precise  state- 
ment of  the  facts  of  sickness  —  we  have  rates  of  27-3  per 


54  RACE  DECADENCE 

1,000  for  males  and  31.2  per  1,000  for  females,  including 
all  sicknesses;  for  sicknesses  involving  incapacity  for  work, 
the  rates  for  ages  15  and  over  were  23.2  per  1,000  for  males 
and  25.7  per  1,000  for  females.  Broadly  speaking,  over 
2.5  per  cent  of  the  working  population  canvassed  were  sick 
and  unable  to  work  at  the  time  of  the  survey. 

The  chief  causes  of  disability  were  73  cases  of  rheumatism, 
37  cases  of  tuberculosis  of  the  lungs,  34  cases  of  cerebral 
hemorrhage  and  paralysis,  and  25  cases  of  mental  alienation 
(insanity).  There  were  also  56  persons  disabled  by  chronic 
headache  and  neurasthenia,  and  29  cases  of  ulcers  and  other 
diseases  of  the  stomach.  Childbirth  and  the  conditions  in- 
cidental to  childbearing  caused  25  cases  of  disability.  Other 
diseases  and  conditions  were  represented  by  smaller  num- 
bers, but  were  nevertheless  of  particular  interest  from  a 
public  health  standpoint.  Four  cases  of  typhoid  fever,  16 
cases  of  acute  infectious  diseases  of  children,  namely, 
measles,  scarlet  fever,  whooping  cough,  and  diphtheria,  were 
reported.  Twelve  of  this  group  of  diseases  were  cases  of 
whooping  cough. 

Among  the  137  cases  of  sickness  which  did  not  result  in 
disability  for  work,  the  largest  number  were  rheumatism,  26 
cases,  diseases  of  the  nervous  system,  neurasthenia,  chronic 
headaches,  etc.,  14  cases,  and  diseases  of  the  stomach,  other 
than  ulcers,  10  cases. 

The  sickness  rates  developed  by  this  survey  are  for  many 
reasons  minimal.  Seasonal  conditions  were  favorable  in  a 
month  which  for  Rochester  has  less  mortality  than  the 
monthly  average  for  the  year.  The  application  of  the  sick- 
ness rates  derived  from  the  survey  to  the  computation  of 
the  sickness  losses  in  the  community  generally,  will  there- 
fore produce  conservative  figures.  The  estimated  male 
population  of  Rochester  15  years  of  age  and  over  for  this 
year  was  92,552.  On  the  basis  of  the  above  sickness  rates 


SICKNESS  IN  THE  UNITED  STATES  55 

we  may  conclude  that  there  are  throughout  the  year  at  least 
2,147  males  constantly  sick.  This  means  approximately 
644,000  days  of  disability  for  males  alone,  for  we  may 
count  on  300  working  days  per  year  per  individual.  At  an 
average  daily  wage  of  $4,  the  wage  loss  alone  for  a  year  in 
a  city  like  Rochester  would  be  $2,576,000,  and  this  figure 
does  not  include  the  cost  of  medical  attendance,  drugs, 
nursing,  etc. 

A    SICKNESS    SURVEY   OF    NORTH    CAROLINA 

There  were  1,881  cases  of  illness  among  66,007  persons 
canvassed,  or  a  rate  of  28.8  per  1,000  of  all  ages.  This 
means  that  nearly  3  per  cent  reported  sick  among  the  popula- 
tion reached.  These  figures  compare  unfavorably  with  those 
of  .Rochester,  where  the  corresponding  ratio  was  less  than 
2.5  per  cent. 

Rheumatism  (all  forms)  is  again  the  most  important 
single  condition,  being  responsible  for  9.3  per  cent  of  all 
cases  and  for  a  rate  of  213.6  per  100,000;  the  rate  in  Roch- 
ester was  211.7.  In  the  federal  census  of  sickness  in  1890 
it  was  likewise  found  that  the  various  forms  of  rheumatism 
together  constituted  the  largest  single  item  in  the  list  of 
diseases;  at  that  time,  however,  the  rate  obtained  was  432 
per  100,000  or  over  twice  that  of  these  recent  studies. 

General  diseases  were,  as  a  group,  responsible  for  the 
largest  share  of  the  morbidity,  accounting  altogether  for  859 
cases  per  100,000  examined  (37.5  per  cent  of  all  cases)  ; 
diseases  of  the  nervous  system  and  of  the  organs  of  special 
sense  came  next,  with  a  rate  of  286.3  per  100,000  (12.6  per 
cent  of  the  total  morbidity).  The  relationship  was  exactly 
reversed  in  Rochester ;  diseases  of  the  nervous  system  stood 
first,  with  a  rate  of  429.9  per  100,000  (25.7  per  cent)  and 
the  general  diseases  came  next  with  a  rate  of  only  481.3  per 
100,000  (25.1  per  cent).  Mental  alienation  (insanity)  was 


56  RACE  DECADENCE 

responsible  for  only  i.i  per  cent  of  the  morbidity  of  North 
Carolina,  in  contrast  to  3.8  per  cent  in  Rochester.  The  lesser 
prominence  of  nervous  diseases  in  North  Carolina  is  per- 
haps the  result  of  the  mode  of  life  in  a  state  largely  rural 
in  character,  in  contrast  with  that  of  an  industrial  urban 
community  like  Rochester. 

A  little  over  3  per  cent  of  the  population  reached  in  North 
Carolina  at  ages  15  years  and  over,  are  constantly  sick,  and 
in  80.4  per  cent  the  illness  is  serious  enough  to  render  them 
unable  to  work.  This  figure  is  somewhat  higher  than  that 
found  in  Rochester,  but  not  materially  so.  On  the  basis  of 
the  sickness  rate  (with  disability)  for  ages  15  and  over,  we 
obtain  the  very  interesting  deduction  that  the  average  num- 
ber of  days  of  disability  per  annum,  per  capita  of  popula- 
tion, is  7.6  for  white  males  and  10.2  for  white  females.  The 
corresponding  figures  for  the  colored  race  are  7.4  for  males 
and  11.3  for  females.  These  results  are  in  very  close  agree- 
ment with  the  best  data  available  from  other  sources,  both 
American  and  European,  as  to  the  number  of  days  of  dis- 
ability per  person  per  year.  The  latest  German  figures 
covering  the  year  1913  give  8.8  days  for  males  and  9.8  for 
females  insured  in  the  sickness  societies  of  that  country. 
According  to  these  figures  we  would  conclude  that  from  2.5 
to  3  per  cent  of  the  community  at  the  working  ages  are  con- 
stantly sick,  involving  a  loss  of  about  9  working  days  per 
person  per  year  in  the  entire  population. 

A    SICKNESS    SURVEY    OF    BOSTON 

In  all  1,902  cases  of  sickness  were  recorded.  This  is 
equivalent  to  a  rate  of  19.6  persons  sick  in  1,000  persons 
canvassed,  or  about  2  per  cent.  The  sickness  rate  is  fairly 
constant  for  each  of  the  several  districts  in  Boston.  The 
rate,  as  a  whole,  is  distinctly  lower  than  in  other  surveys. 
It  is  of  course  possible  that  the  very  favorable  condition 


SICKNESS  IN  THE  UNITED  STATES  57 

shown  for  Boston  is  in  part  the  result  of  the  season  of  the 
year  when  the  survey  was  made,  namely,  the  midsummer. 

The  following  are  the  principal  findings  of  the  Boston 
survey : 

1.  Close  to  2  per  cent  of  the  population  of  Boston  was 
sick. 

2.  Slightly  more  than  90  per  cent  of  the  total  cases  of 
sickness  involved  disability  for  work. 

3.  The   principal    diseases    responsible    for   the   sickness 
registered  were  rheumatism,  organic  diseases  of  the  heart, 
tuberculosis  of  the  lungs,  diseases  of  the  kidneys,  and  dis- 
eases and  conditions  of  the  puerperal  state. 

4.  The  proportion  of  cases  sick  less  than  one  month  up 
to  the  date  of  the  survey  was  only  26.3  per  cent  of  the  total. 
Th^is  was  slightly  higher  than  the  finding  for  Rochester,  New 
York,  but  considerably  lower  than  the  proportion  of  cases 
sick  less  than  one  month  in  North  Carolina. 

5.  Of  the  total  cases  72.9  per  cent  received  medical  atten- 
tion ;  this  is  a  higher  percentage  than  that  developed  in  either 
of  the  preceding  surveys.    This  finding  reflects  the  excellent 
medical  facilities  available  in  the  city  of  Boston. 

6.  The  economic  loss  resulting  from  sickness  in  Boston 
is  considerable,  involving  the  loss  of  earnings  for  about  7 
days  per  person  per  year. 

CONCLUSIONS    FROM    THE   PITTSBURGH    SURVEY 

The  following  are  the  principal  findings  in  a  similar  sur- 
vey of  sickness  in  Pittsburgh: 

1.  A  little  over  1.5  per  cent  of  the  population  was  reported 
sick.     This  rate  is  the  lowest  as  yet  found  in  any  of  the 
surveys. 

2.  Nearly  96  per  cent  of  the  total  cases  of  sickness  in- 
volved disability  for  work. 

3.  The  principal  diseases  and  conditions  responsible  for 


58  RACE  DECADENCE 

disability  were  the  accidents  and  injuries,  rheumatism,  in- 
fluenza, tuberculosis,  colds,  and  the  mental  disorders.    , 

4.  Of  all  the  cases  of  sickness  recorded,  75.8  per  cent 
received  medical  attention. 

5.  The  average  loss  in  days  from  sickness  per  male  worker 
in  Pittsburgh  is  estimated  as  over  6  days,  while  that  for 
females  was  somewhat  under  this  figure,  namely,  5.5  days. 

DISABILITY  BY  AGE  AND  OCCUPATION  1 

With  the  exception  of  the  estimates  furnished  by  the 
recent  health  surveys  of  the  Metropolitan  Life  Insurance 
Company,  and  some  fragmentary  data  based  upon  the  expe- 
rience of  certain  established  funds,  no  exact  measurement 
has  ever  been  made  of  the  annual  average  number  of  dis- 
ability days  per  wage-earner  by  age  and  occupation  in  the 
United  States.  The  study  of  the  Federal  Bureau  of  Labor 
Statistics  upon  which  this  article  is  based  furnishes,  there- 
fore, the  first  official  and  exact  measurement  of  such  dis- 
ability among  wage-earners. 

The  results  obtained  in  connection  with  the  study,  show 
an  average  annual  number  of  disability  days  of  6.6.  This 
figure  is  to  be  considered  as  reliable  because  it  is  an  actual 
measurement  and  not  an  estimate;  it  is  based  upon  the  dis- 
ability experience  of  more  than  40,000  wage-earning  persons 
engaged  in  over  forty-two  separate  and  distinct  occupations. 
Seven  days,  or  thereabout  may,  therefore,  be  said  to  be 
the  annual  average  number  of  disability  days  per  wage- 
earner  in  the  United  States. 

One  of  the  exceptions,  more  apparent  than  real,  seems 
to  be  tobacco  and  cigar  workers  who,  because  of  their  work, 
are  known  to  be  frequently  affected  with  tuberculosis,  which 
is  in  these  workers  an  industrial  disease.  The  group  of 


1  This   section   is  based   upon   data   contained   in   an   unpublished 
study  made  recently  by  the  United  States  Bureau  of  Labor  Statistics. 


SICKNESS  IN  THE  UNITED  STATES  59 

workers  shows  an  average  disability  of  8.01  days  per  year 
per  worker  as  against  6.6 1  days  per  year  which  is  the  aver- 
age for  all  occupations. 

Miners  show  the  highest  annual  average  number  of  dis- 
ability days,  9.7  as  against  6.61,  the  average  for  all  occupa- 
tions. Freight  handlers  are  the  next  group  in  point  of 
disability,  with  an  average  number  of  disability  days  per 
member  of  9.6  days  per  year.  Drivers,  with  an  average  of  8.6 
days  of  disability  per  member,  come  next.  Jewelers  and 
professional  workers  show  the  least  extent  of  sickness,  3.6 
and  2.6  days,  respectively,  per  year.  The  high  disability 
extents  of  the  first  three  groups  is  accounted  for,  no  doubt, 
by  the  hazardous  character  of  the  work  which  makes  for 
frequent  industrial  accidents.  It  is  a  generally  recognized 
fact  {hat  certain  vocations  are  much  more  hazardous  to  health 
than  others. 

The  figures  show  the  following  facts  regarding  the  extent 
of  disability  shown  by  the  average  annual  number  of  dis- 
ability days  per  member.  The  largest  average  number  of 
disability  days,  9.7  per  year,  or  47  per  cent  greater  than  the 
average,  was  found  among  freight  handlers.  The  high 
disability  rate  is,  therefore,  to  be  accounted  for  by  sickness 
due  to  accidents  and  physical  overstrain  which  are  known 
to  be  very  frequent  because  of  the  character  of  certain 
occupations.  The  same  point  may  be  made  regarding  the 
miners,  who  show  the  next  highest  average  number  of  dis- 
ability days,  9.1  per  member,  or  37.9  per  cent  greater  than 
the  average  for  the  entire  group.  Drivers,  with  an  average 
age  of  42  or  about  one  year  below  that  of  the  group,  show 
an  average  disability  days  per  member  of  8.4  days,  or  27.3 
per  cent  greater  than  the  average.  Professional  employees, 
jewelers,  trade,  and  clerical  employees  appear  to  be,  in  the 
order  named,  the  least  sickly  workers.  Respectively,  these 
occupations  show  the  following  extents  of  sickness  below  the 


60  RACE  DECADENCE 

average.     Professional,   56.1   per  cent;   jewelers,  43.9  per 
cent;  trade  and  clerical,  30.3  per  cent. 

SICKNESS  IN   GENERAL 

Judging  from  the  English  and  American  statistics  of  ill- 
ness, we  must  conclude  that  at  all  times  in  the  United  States 
about  3,000,000  persons  are  seriously  ill,  of  whom  about 
500,000  are  consumptives.  Fully  half  of  this  illness  is 
preventable. 

According  to  Farr,  for  every  death  there  is  an  average 
sickness  of  2  years,  or  for  each  death  per  year  there  are 
two  persons  sick  throughout  the  year.  This  would  mean  in 
the  United  States  that,  as  there  are  about  1,500,000  annual 
deaths,  there  always  will  be  about  3,000,000  persons  on  the 
sick  list  which  is  equivalent  to  about  13  days  per  capita.  Other 
authorities  estimate  the  number  of  sick  in  this  country  at  a 
much  higher  figure  —  even  up  to  4,500,000. 

Another  investigator  concludes  that :  "  Out  of  a  popula- 
tion of  110,000,000  only  19,500,000  are  in  full  vigor,  with 
perhaps  37,500,000  in  fair  health.  Almost  one-half  the  popu- 
lation (45,000,000)  is  thought  to  be  more  or  less  physically 
imperfect." 

Davenport  has  pointed  out  the  startling  fact  that  of  the 
2,000,000  persons  who  are  annually  cared  for  in  our  hos- 
pitals and  asylums,  500,000  are  mental  defectives;  and  of 
over  180,000  paupers  and  criminals,  by  far  the  great  majority 
owe  their  defects  and  their  dependency  to  bad  heredity  —  to 
defective  germ-plasm. 

One-third  of  Chicago  school  children  have  some  nervous 
disorder,  and  two-thirds  of  New  York  school  children  are 
reported  physically  defective. 

The  reports  of  the  Chief  Medical  Officer  to  the  Board 
of  Education  shows  that  of  the  6,000,000  children  registered 
in  the  public  schools  of  England  and  Wales,  far  more  than 


SICKNESS  IN  THE  UNITED  STATES  6 1 

half  of  them  exhibit  very  pronounced  evidence  of  inherent 
constitutional  weakness. 

In  order  to  find  and  then  correct  defects  of  eyes,  ears, 
teeth,  etc.,  and  properly  apply  our  hygienic  knowledge,  med- 
ical inspection  of  schools  is  necessary.  Such  inspections  as 
have  been  made  disclose  an  astonishing  amount  of  ill  health, 
the  percentage  of  morbidity  being  from  20  to  60  per  cent. 
The  committee  of  physical  welfare  of  school  children  in 
New  York  found  that  66  per  cent  needed  medical  or  sur- 
gical attention  or  better  nourishment;  40  per  cent  needed 
dental  care;  38  per  cent  had  enlarged  glands  of  the  neck; 
31  per  cent  defective  hearing;  18  per  cent  enlarged  tonsils. 

The  death-rate  has  declined,  as  Dr.  Tredgold  well  remarks, 
"  not  because  the  nation  is  more  resistant  to  disease,  but 
because  modern  science  has  lessened  its  frequency  and 
modern  skill  in  treatment  has  diminished  its  fatality." 

It  was  once  believed  that  human  mortality  followed  an 
"  inexorable  law."  Facts,  however,  show  that  mortality  varies 
in  different  places,  that  heredity  has  much  to  do  with 
longevity,  and  that  the  death-rate  is  decreased  by  hygienic 
living  and  improved  sanitation.  The  length  of  life  in  Sweden 
and  Denmark  is  over  50  years ;  in  the  United  States  and 
England,  about  45  ;  in  India  less  than  35  years. 

SPECIAL  DISEASES 

Heart  disease  now  stands  at  the  top  of  the  mortality 
tables  for  the  United  States.  Over  7,000,000  people  now 
living  will  die  of  some  form  of  heart  trouble;  while  over 
6,000,000  of  those  now  living  are  destined  to  die  of  pneu- 
monia. 

The  death-rate  from  the  degenerative  diseases  of  the 
heart,  blood  vessels,  and  kidneys,  including  apoplexy,  has 
increased  over  100  per  cent  since  1880.  These  diseases  claim 
about  400,000  lives  annually.  Fully  60  per  cent  of  these 


62  RACE  DECADENCE 

deaths  are  preventable  or  postponable  if  the  disease  is  dis- 
covered in  time. 

There  are  constantly  ill  in  the  United  States  of  tuber- 
culosis about  500,000  persons,  of  whom  about  one-half  are 
totally  incapacitated,  while  the  remainder  are  half  incapaci- 
tated. 

Cancer,  a  baffling  disease,  possibly  of  the  degenerative 
class,  to  which  our  people  in  their  present  physical  condi- 
tion are  highly  susceptible,  claims  75,000  lives  annually  and 
is  increasing  very  fast.  Reported  deaths  from  external  can- 
cer alone  have  increased  52  per  cent  in  ten  years. 

Over  25,000  Americans  are  still  sacrificed  annually  to 
that  preventable  filth  disease  —  typhoid  fever.  About  300,000 
annually  suffer  from  it  and  are  more  or  less  impaired  by 
some  of  its  after-effects. 

Hookworm  disease  in  the  South  is  a  chief  cause  of  incapaci- 
tation,  especially  among  the  poor  whites.  For  this  reason 
the  hookworm  has  been  nicknamed  the  "  germ  of  laziness." 
It  is  believed  that  a  sufferer  from  hookworm  disease  is  in- 
capacitated from  one-fourth  to  one-half  the  time. 

Malaria  is  one  of  the  diseases  which  are  fatal  relatively 
seldom,  but  which  shorten  life  by  predisposing  to  other 
causes  of  death  and  narrows  life  by  reducing  working  effi- 
ciency by  a  large  percentage.  Doctor  Howard  states  that  each 
year  there  are  probably  3,000,000  cases  of  malaria  in  the 
United  States,  most  of  which  are  in  the  South.  This  is  prac- 
tically all  preventable. 

Those  who  neglect  colds,  or  what  seem  to  be  colds,  will 
be  far  more  likely  to  become  victims  of  tuberculosis  or 
pneumonia.  No  reliable  statistics  of  the  prevalence  of  minor 
ailments  exist.  Physicians,  whose  experience  gives  them 
good  opportunity  to  judge,  place  the  time  lost  annually  for 
each  person  from  minor  ailments  at  three  or  more  days  a 
year. 


SICKNESS  IN  THE  UNITED  STATES  63 

Venereal  diseases,  together  with  cancer,  tuberculosis,  and 
the  "  old-age  "  disorders  will  be  more  fully  discussed  in  sub- 
sequent chapters. 

ACCIDENTS   AND  VIOLENCE 

About  100,000  Americans  are  killed  annually  by  accidents 
and  various  forms  of  violence.  Our  efforts  to  prevent  the 
steady  increase  of  this  waste  have  not  been  wholly  successful. 

American  railways  in  one  year  killed  nearly  12,000  and 
injured  over  100,000  persons.  The  deaths  and  disablements 
from  accidents  in  industry  represent  a  great  and  needless 
impairment  of  efficiency. 

John  Mitchell  once  estimated  that  for  every  hundred 
thousand  tons  of  coal  produced  in  the  United  States  one 
minet  worker  is  killed  and  several  injured. 

Suicides  are  increasing  and  will  soon  reach  the  enormous 
total  of  15,000  annually. 

Over  10,000  murders  are  committed  every  year,  and  it  is 
estimated  that  but  an  average  of  one  in  116  murderers  are 
executed  for  their  crimes.  We  have  the  appalling  estimated 
homicide  record  of  over  100  per  1,000,000  population,  as 
against  7  in  Canada,  9  in  Great  Britain,  and  15  in  Italy. 

It  is  startling  to  be  told  that  there  are  more  inmates  in 
institutions  for  the  insane  than  there  are  students  in  all  the 
colleges  and  universities  of  the  country.  This  whole  ques- 
tion of  feeble-mindedness  and  insanity  will  be  fully  consid- 
ered in  Part  n  of  this  work. 

FATIGUE  AND   NERVOUS  DISORDERS 

Neurotic  disorders  accompanied  by  undue  fatigue  sensa- 
tions are  responsible  for  an  enormous  amount  of  "  lost  time  " 
and  general  inefficiency  in  this  country.  Not  only  heredity, 
but  also  alcohol,  tobacco,  and  errors  of  diet  contribute  either 
directly  or  indirectly  to  this  sort  of  semi-nervous  exhaustion. 


64  RACE  DECADENCE 

When  excessive  amounts  of  the  protein  element  in  food 
(exemplified  in  white  of  egg  or  the  lean  part  of  meat)  are 
eaten,  they  putrefy  in  the  large  intestine,  producing  auto- 
intoxication. For  this  and  other  reasons  there  is  a  present 
tendency  among  physiologists  to  advise  a  reduction  in  the 
use  of  such  foods  from  the  amounts  customary  in  many 
countries,  and  especially  in  the  United  States.  Auto-intoxi- 
cation induces  fatigue.  The  endurance  of  those  using  high 
protein  and  of  those  using  low  protein  shows  in  general,  al- 
though with  some  exceptions,  that  the  former  have  less 
endurance  than  the  latter. 

As  a  rule,  this  elusive  fatigue  is  associated  with  some  sort 
of  functional  nervous  disorder  which,  in  turn,  may  owe  its 
existence  to  numerous  and  varied  causes  —  not  excepting 
hereditary  predisposition. 

CAUSES  OF  NERVOUS  DISORDERS 

1.  Heredity  plays  a  vital  part  in  disorders  of  the  nervous 
system.     Over  90  per  cent  of  these  cases  show  a  distinctly 
tainted  (neurotic)  ancestry  in  their  history.    This  hereditary 
taint  runs  all  the  way  up  from  worry  and  temperamental 
peculiarities  to  alcoholism  and  insanity. 

2.  Chronic  fear  of  some  sort  is  the  fundamental  mental 
state  which  is  characteristic  of  the  vast  majority  of  these 
patients.     Faith  is  the  mental  medicine  which  is  essential  to 
their  cure.     Faith  in  a  patent  medicine,  a  new  cult,  a  quack 
doctor,   or   a   quack   preacher,  in   a   new   system   of    fake 
medicine  or  a  new  religion  —  they  all  work  equally  well. 

3.  Among  the  more  common  factors  of  worry  and  nervous- 
ness may  be  mentioned  supposed  inherited  fears  and  pre- 
natal markings,  definite  dreads,  hoodoos,  muscular  tension, 
mental  and  motor  obsessions,  such  as  counting  one's  steps, 
etc.,  not  to  mention  numerous  health  fads  and  practices. 

4.  A  careful  analysis  of  almost  a  thousand  histories  does 


SICKNESS  IN  THE  UNITED  STATES  65 

not  show  "Americanitis,"  or  our  so-called  high-pressure 
living,  to  be  such  a  large  factor  in  their  causation  as  one 
might  naturally  suspect.  While  overwork  is  an  occasional 
factor  of  prominence,  on  careful  analysis,  it  usually  proves 
to  have  been  a  case  of  overworry,  quite  often  associated 
with  overeating. 

To  recapitulate,  the  known  causes  of  "  nerves  "  in  the 
order  of  their  frequency  and  importance,  are: 

1.  Heredity. 

2.  Abnormal  mental  habits  and  defective  will  training. 

3.  Occupational  factors  —  living  and  working  conditions. 

4.  Bad  physical  habits  and  unhygienic  practices. 

5.  Associated  physical  diseases  or  other  functional  com- 
plications. 

6.  Chronic  poisoning  —  derangements  of  metabolism,  dis- 
ease toxins,  and  drugi  poisons,  such  as  alcohol,  tobacco, 
tea,  coffee,  etc. 

7.  Psychologic  influences,  prejudices,  worries,  etc. 

8.  City  life  and  modern  high  tension. 

PROLONGATION  OF  LIFE 

Professor  Irving  Fisher,  in  his  discussion  of  life  exten- 
sion, says: 

It  is  impossible  to  estimate  the  effect  on  the  length  of  life  of  the 
partial  elimination  of  various  diseases.  Using  the  statistics,  ex- 
perience, and  estimate  of  eighteen  physicians  as  to  the  preventability 
of  each  of  the  list  of  ninety  causes  of  death,  we  find  that  the  length 
of  life  could  easily  be  increased  from  45  to  60,  an  increase  of 
one-third,  or  15  years.  This  would  result  in  a  permanent  reduc- 
tion to  death-rate  of  about  25  per  cent.  The  principal  reductions 
would  be  from  infantile  diarrhea  and  enteritis,  over  60  per  cent  of 
which  could  be  prevented,  with  the  result  of  an  addition  to  the 
average  length  of  life  of  2.32  years.  Broncho-pneumonia,  also  an 
infant  disease  cculd  be  prevented  to  the  extent  of  50  per  cent, 
whereby  life  would  be  lengthened  by  0.60  year.  Meningitis,  which 
15  usually  fatal  at  the  age  of  2,  could  be  prevented  by  at  least  70 


66  RACE  DECADENCE 

per  cent,  and  this  prevention  would  lengthen  the  average  life  by 
0.60  year.  Eighty-five  per  cent  of  death  by  typhoid  fever  is  un- 
necessary, and  if  avoided  would  lengthen  life  at  least  0.65  year. 
It  would  be  feasible  to  prevent  at  least  75  per  cent  of  cases  of 
tuberculosis  of  the  lungs,  and  thereby  to  lengthen  life  by  about 
2  years.  If  the  deaths  from  violence  were  reduced  only  35  per  cent, 
human  life  would  be  increased  by  0.86  year.  The  prevention  of 
45  per  cent  of  cases  of  pneumonia  would  lengthen  life  by  0.94  year. 
These  seven  diseases  alone  could  easily  be  reduced  by  these  amounts 
so  as  to  lengthen  life  by  8  years.  This  could  be  done  simply 
through  insistence  by  the  public  on  pure  milk,  pure  water,  pure  air, 
and  reasonable  protection  from  accidents. 

OLD   AGE   IN   SPITE   OF  DISEASE 

Notwithstanding  the  dictum  of  the  psalmist,  who  pre- 
scribed, for  the  average  span  of  human  life,  the  proverbial 
"  three  score  years  and  ten,"  we  believe  that  in  the  light  of 
our  present  scientific  knowledge  and  in  view  of  all  the  means 
and  methods  which  we  possess  of  combating  disease  and 
promoting  health,  the  average  sane  and  healthy  human  being 
(except  those  belonging  to  hereditarily  short-lived  strains) 
could  easily  live  to  be  a  hundred  years  of  age. 

The  recent  census  (1920)  has  disclosed  that  we  still  have 
a  few  centenarians  left  in  this  country,  and  we  believe  that 
the  future  will  enable  old  men  and  women  to  be  more  efficient 
than  heretofore,  and  that  there  will  be  little  talk,  in  coming 
generations,  of  chloroforming  our  older  citizens  upon  reach- 
ing the  age  of  60  years. 

John  Shell  seems  to  be  still  living  in  Leslie  County,  Ken- 
tucky, and  at  this  writing  is  alleged  to  be  over  131  years 
old.  He  is  said  to  be  in  fair  possession  of  his  faculties,  and 
not  infrequently  rides  twenty  miles  a  day  on  horseback.  The 
evidence  available,  however,  suggests  that  this  man  is  prob- 
ably not  over  100  years  old. 

In  Prussia,  a  woman  is  reported  alive  at  125  years,  having 
recently  lost  two  children,  one  dying  at  89  and  the  other  at 
100  years. 


SICKNESS  IN  THE  UNITED  STATES  67 

Mrs.  Margaret  Edminson,  Mt.  Vernon,  Illinois,  is  now 
1 20  years  old  and  well  preserved;  is  in  full  possession  of  her 
faculties  and  doesn't  even  wear  glasses. 

Mrs.  Mary  A.  Potter,  Dwight,  Illinois,  is  106  years  old. 
James  McGowan,  Wilton,  Illinois,  is  104  years  old,  walks 
several  miles  a  day  and  is  enjoying  excellent  health,  while 
John  Harouff,  of  Chicago,  has  passed  his  iO4th  birthday  and 
is  hale  and  hearty. 

Mrs.  Anna  Casperson,  of  Chicago,  is  over  103  years  old; 
has  worked  hard  all  her  life,  and  offers  work  as  a  recipe 
for  long  life.  Mrs.  Anna  Burian,  of  Chicago,  is  also  103 
and  is  hale  and  hearty. 

Others  100  years  old  or  over  are:  Timothy  Carmody  of 
Aurora,  103,  and  Mrs.  B.  Mulligan  of  Aurora,  100. 

Flourens  claims  that  mammals  should  live  to  a  period 
equal  to  not  less  than  five  times  the  period  of  attaining  full 
growth.  If  this  rule  is  applied  to  the  human  species,  it 
would  make  the  average  life  of  man  about  100  years,  as  we 
are  nearly  twenty  years  attaining  our  full  development. 

It  has  come  to  the  place  where  it  really  seems  that  most 
human  beings,  when  they  are  not  engaged  in  something 
which  contributes  indirectly  to  their  untimely  death,  are 
engaged  in  other  practices  which  directly  contribute  to 
bringing  about  various  forms  of  sickness  and  other  causes 
of  minor  disability,  which  so  greatly  cripple  their  health  and 
handicap  their  usefulness. 

THE  "  HEALTH   SPAN  "  OF  LIFE 

The  span  of  life  in  this  country  is  about  sixty  years,  and 
for  a  century  or  so  we  have  had  in  our  minds  the  extension 
of  this  average  life  span  beyond  the  sixty  years.  But  these 
sixty  years  are  not  sixty  health  years;  just  sixty  years  of 
living,  full  of  more  or  less  ill  health  and  physical  decrepitude. 
The  "  health  span  "  of  life,  as  Dr.  Eugene  Fisk  calls  it,  is 


68  RACE  DECADENCE 

a  much  more  important  matter  than  the  length  of  life.  That 
"  health  span  "  is  just  about  ten  years.  When  our  robust, 
healthy  citizens  learn  the  fact  that  no  matter  how  long  they 
live,  they  are  certain  of  only  ten  years  of  exuberant  well- 
being,  they  are  going  to  stop  a  moment  in  the  rush  of  things 
and  take  thought.  They  are  going  to  insist  on  physicians 
lengthening  that  "  health  span ;"  and  as  soon  as  the  physi- 
cians also  learn  this  fact,  which  few  now  know,  they  too  will 
turn  their  attention  to  the  healthy  people  and  do  their  part 
to  extend  the  "  health  span  "  of  the  race.  The  ailments  that 
impair  health  are  mostly  minor  and  remediable,  forerunners 
perhaps,  but  not  the  serious  disorders  from  which  people  die. 

Says  one  writer:  "  More  than  16,000,000  children  of  our 
22,000,000  now  in  the  public  schools  have  physical  defects, 
most  of  them  preventable  and  remediable,  such  as  heart 
and  lung  diseases,  disorders  of  sight  and  hearing,  diseased 
adenoids  and  tonsils,  flat-feet,  weak  spines,  imperfect  teeth 
and  malnutrition,  and  among  them  I  per  cent  of  mental 
defect."  These  facts  are  mentioned  to  show  how  much 
work  there  is  to  be  done  by  physicians  among  the  supposedly 
healthy  members  of  any  community. 

For  the  full  discussion  of  the  Economic  Losses  from 
Sickness,  the  reader  is  referred  to  Appendix  B  —  where 
the  author  has  endeavored  to  present  the  more  recent  esti- 
mates of  the  leading  authorities  and  investigators  who  have 
been  engaged  in  the  study  of  this  phase  of  economics. 

SUMMARY  OF  THE  CHAPTER 

1.  Health  is  our  greatest  national  resource.     We  suffer 
enormously  from  sickness  which  is  largely  preventable.    We 
need  a  national  health  revival. 

2.  Sickness  is  responsible  for  much  of  our  poverty,  failure, 
misery,  inefficiency,  and  social  and  domestic  friction. 

3.  Heredity  is  also  a   factor  in  the  general  picture  of 
human  sickness,  sorrow,  and  premature  death. 


SICKNESS  IN  THE  UNITED  STATES  69 

4.  Let  us  avoid  "  health  fads  "  and  shun  hygienic  extremes. 

5.  In  the  sickness  surveys  of  376,573  people,  8,636  were 
disabled ;  experiencing  the  loss  of  almost  7  working  days  per 
year  per  person. 

6.  In  Pennsylvania  they  found  4.28  per  cent  of  the  popula- 
tion sick  all  the  time. 

7.  In  Ohio  they  found  3  per  cent  sick  constantly ;  and  each 
working  person  losing  9  days  per  year  from  sickness. 

8.  In  Philadelphia  4.28  per  cent  of  the  people  were  found 
to  be  sick  all  the  time ;  in  Rochester,  New  York,  2.5  per  cent 
of  the  working  population  was  found  sick. 

9.  The  North  Carolina  survey  showed  3  per  cent  of  the 
people  sick  all  the  time;  rheumatism  being  the  chief  com- 
plaint. 

10.  In  Boston  2  per  cent  were  found  disabled  and  the 
chief     ailments   were    rheumatism,    heart    disorders,    and 
tuberculosis. 

11.  The  average  disability  for  adult  workers  in  this  coun- 
try is  just  about  7  days  per  year  as  compared  with  9  days 
for  Europeans. 

12.  In  the  United  States  3,000,000  persons  are  sick  all 
the  time;  500,000  of  this  number  are  consumptives.     Some 
estimate  4,500,000  constantly  ill. 

13.  For  every  death  there  is  an  average  sickness  of  two 
years. 

14.  Out  of   110,000,000  population  less  than  20,000,000 
are  in  robust  health  ;  37,500,000  are  in  fair  health;  about  one- 
half  (45,000,000)  are  physically  imperfect. 

15.  Of  the  2,000,000  persons  cared  for  in  public  institu- 
tions each  year,  500,000  are  mentally  defective,  and  almost 
200,000  paupers  and  criminals. 

16.  One-third  of   Chicago  school  children  are  nervous; 
and  two-thirds  of  New  York  pupils  are  physically  defective. 

17.  One-half  of  the  school  children  of  Great  Britain  are 
suffering  from  constitutional  weakness. 

18.  Medical  inspection  of  the  schools  is  one  of  the  crying 
needs  of  the  times. 

19.  Over   7,000,000   persons   now   living   in   the   United 
States  will  die  of  heart  disorders;  over  6,000,000  of  pneu- 
monia. 


70  RACE  DECADENCE 

20.  Since  1880  the  death-rates  for  the  degenerative  dis- 
eases (heart,  arteries,  and  kidney)  have  increased  over  100 
per  cent.    They  claim  400,000  lives  annually  at  present. 

21.  Cancer  kills  75,000  annually;  and  typhoid  still  claims 
25,000  each  year. 

22.  Venereal  diseases,  malaria,  and  hookworm  disorders 
are  still  to  be  conquered.     There  are  still  3,000,000  cases  of 
malaria  in  the  country. 

23.  One  hundred  thousand  Americans  die  annually  from 
accidents  and  violence.    The  railroads  kill  12,000  and  injure 
over  100,000  every  year. 

24.  One  miner  is  killed  for  every  hundred  thousand  tons 
of  coal  taken  out  of  the  earth. 

25.  There  are  over  10,000  murders  a  year  and  only  one  in 
every  116  murderers  are  executed. 

26.  There  are  more  inmates  in  the  insane  asylums  than 
there  are  students  in  all  our  colleges  and  universities. 

27.  Functional  nervous  disorders  seem  to  be  greatly  on 
the  increase  in  recent  years. 

28.  The  causes  of  our  nervous  disorders  are:  heredity, 
fear,  working  conditions,  bad  habits,  disease,  and  modern 
high  tension. 

29.  In  spite  of  the  increase  in  disease,  we  still  find  a 
considerable  number  of  centenarians  alive  in  this  country. 

30.  The  "  health  span  "  of  life  in  this  country  is  only  about 
ten  years.    We  live  almost  sixty  years  —  but  on  the  average 
enjoy  only  ten  years  of  good  health  for  each  individual. 


CHAPTER  V 

TRIUMPHS  AND  FAILURES  OF  PREVENTIVE 
MEDICINE 

IT  IS  almost  universally  conceded  that  during  the  past 
twenty-five  years  enormous  advances  have  been  made  in 
hygiene,  sanitary  science,  and  preventive  medicine,  not  to 
mention  curative  medicine,  surgery,  etc.  While  we  are  justi- 
fied in  congratulating  ourselves  on  all  the  advances  made  in 
this  important  work  of  preventing  disease  and  promoting 
health,  perhaps  it  would  be  well  to  sort  of  strike  a  trial  bal- 
ance and  actually  find  out  just  where  we  are  gaining,  where 
we  are  losing,  and  about  where  we  are  standing  still.  It  will 
be  the  purpose  of  this  chapter,  first,  to  consider  the  triumphs 
of  preventive  medicine  during  the  last  forty  or  fifty  years, 
and  then  clearly  to  point  out  our  present  failures  and  defeats, 
that  the  reader  may  gain  a  clear  idea  of  the  present  status 
of  the  health  movement  in  America. 

ANCIENT    SANITATION 

The  science  of  sanitation  goes  back  to  the  dawn  of  his- 
tory —  back  to  those  wonderful  civilizations  of  five  thousand 
years  and  more  ago.  The  early  beginnings  of  sanitary  sci- 
ence and  preventive  medicine  are  to  be  found  in  Assyria  and 
Babylonia,  Egypt  and  Crete,  Greece  and  Rome. 

One  of  the  earliest-known  civilizations  of  the  world  was 
that  of  the  ancient  Sumerians,  who  inhabited  the  broad  valley 
north  of  the  Persian  Gulf  between  the  Tigris  and  Euphrates 
rivers,  now  called  Mesopotamia.  Recent  excavations  have 
shown  that  the  dwellings  of  these  people  were  provided  with 


72  RACE  DECADENCE 

drains  and  other  sanitary  conveniences.  Since  the  country 
was  flat  and  the  soil  sandy,  the  work  was  individual  and  not  a 
community  enterprise.  No  attempt  was  made  to  build  sewers 
for  these  municipalities  of  six  thousand  years  ago,  but  each 
householder  constructed  his  own  drain  and  cesspool  after  the 
manner  of  the  Arabians  of  the  present  day. 

One  writer  suggests  that  "  The  Egyptians  worshiped  the 
scarabaeus,  or  dung  beetle,  possibly  recognizing  its  scaveng- 
ing powers  and  its  contribution  to  sanitation."  Herodotus 
tells  us  that  the  Egyptians  kept  their  houses  clean,  bathed 
frequently,  and  attempted  to  obtain  unpolluted  water  for 
drinking  purposes. 

But  the  ancient  Hebrews  were  the  real  founders  of  the 
modern  public  health  movement.  The  laws  of  Moses  (born 
about  1600  B.C.)  contained  numerous  hygienic  laws  and 
ordinances,  most  of  which  apply  just  about  as  well  today  as 
they  did  when  they  were  first  promulgated.  The  influence  of 
Egyptian  learning  on  Moses  and  his  work  is  suggested  by  this 
passage  from  the  Bible :  "And  Moses  was  learned  in  all  the 
wisdom  of  the  Egyptians,  and  was  mighty  in  words  and  in 
deeds."  (Acts  7:22.) 

The  ancient  city  of  Jerusalem  was  well  sewered  and  had  a 
good  water  supply.  Previous  to  the  eighth  century  before 
Christ  the  city  had  two  aqueducts,  one  from  the  pools  of  Solo- 
mon and  the  other  from  the  pools  of  Hezekiah,  outside  the 
city  walls.  "  In  727  B.C.  King  Hezekiah  built  a  vast  reservoir, 
called  the  pool  of  Siloam,  near  the  gates  of  Jerusalem.  The 
existing  water  supply  was  insufficient  to  fill  it,  so  he  con- 
structed a  tunnel  through  the  solid  rock  of  a  hill  behind  the 
city.  His  workmen  began  at  both  ends  and  met  accurately  in 
the  middle." 

The  most  extensive  and  elaborate  sanitary  engineering  of 
olden  times  has  been  recently  brought  to  light  on  the  island 
of  Crete.  The  ancient  palace  at  Cnosus  dating  back  to  about 


TRIUMPHS,  FAILURES  OF  MEDICINE  73 

2100  B.C.,  has  a  wonderfully  complete  system  of  drainage 
and  sanitation. 

Cyrus  (559-529  B.C.)  was  a  wise  military  commander  and 
is  said  always  to  have  taken  provisions  and  drinking  water 
from  home  when  on  his  military  campaigns.  He  had  the 
water  boiled,  suggesting  that  the  value  of  this  common  process 
of  sterilization  was  known  to  these  ancient  peoples. 

One  authority  gives  the  following  bit  of  interesting  infor- 
mation : 

In  America  the  oldest  evidence  of  sanitary  science  is  given  by  the 
wells  along  the  valley  of  the  Mississippi,  which  are  believed  to  have 
been  built  by  primitive  peoples  many  centuries  before  Christ.  One 
in  particular  in  the  hills  of  Yucatan  is  worthy  of  mention  because 
it  is  bored  to  a  depth  of  100  feet  and  then  through  a  horizontal 
gallery  2,700  feet  long  before  water  is  reached. 

In  625  B.C.  an  engineer  named  Eupalinius  constructed  a 
tunnel  4,200  feet  long  and  8  feet  square  in  order  to  supply 
water  to  the  city  of  Athens.  The  first  sanitary  engineering 
for  Rome  and  Carthage  was  probably  performed  by  Greek 
engineers,  as  the  designs  of  all  are  similar. 

Hippocrates  advocated  the  boiling,  or  filtering  of  all  drink- 
ing water. 

Much  of  Roman  engineering  was  devoted  to  sanitation. 
The  city  of  Rome  had  sewers  as  early  as  800  B.C.  In  735  B.C. 
was  built  the  famous  Cloaca  Maxima,  which  is  still  in  use 
today,  2,656  years  later.  It  is  12  feet  high,  n  feet  wide 
and  is  lined  with  cement.  Every  Roman  street  had  its  lateral 
sewer  diminishing  in  size  as  the  distance  from  the  main  sewer 
increased.  The  great  aqueducts  of  Rome  are  monuments  to 
the  genius  of  their  engineers.  Like  the  sewers,  some  of  them 
are  still  in  use. 

DAWN   OF   MODERN   SANITARY   SCIENCE 

With  the  discovery  of  the  microscope  the  modern  era  of 
preventive  medicine  and  sanitary  science  was  ushered  in. 


74  RACE  DECADENCE 

The  dawn  of  modern  medicine  dates  from  our  ability  to  rec- 
ognize, cultivate,  and  study  microbes.  The  germ  theory  of 
disease  effected  a  complete  revolution  in  sanitary  methods 
and  pointed  a  way  for  those  magnificent  achievements  in 
disease  prevention  which  so  increasingly  characterized  the 
sanitary  efforts  of  the  nineteenth  century  in  general,  par- 
ticularly its  closing  decades. 

Public  health  administration,  with  all  its  details  of  quaran- 
tine regulation  and  contagious  disease  control,  in  fact  the 
whole  far-flung  battle-front,  in  the  struggle  against  conta- 
gious diseases  and  infectious  disorders,  had  been  brought  up 
to  a  point  of  high  efficiency  and  extraordinary  accomplishment 
by  the  dawn  of  the  twentieth  century.  For  untold  ages  the 
microbe  had  reigned  almost  supreme  and  had  worked  at  will 
its  mischievous  career  on  earth,  but  the  moment  the  struggle 
became  one  of  the  microbe  versus  the  microscope  the  death 
knell  of  the  supremacy  of  germ  diseases  was  sounded,  and 
although  the  victory  is  not  yet  completely  won,  the  past  half- 
century  has  been  marked  by  a  succession  of  brilliant  achieve- 
ments on  the  part  of  a  long  list  of  untiring  investigators  who, 
when  we  consider  the  value  of  their  work,  in  the  terms  of 
human  lives  saved,  could  be  appropriately  denominated  "  the 
uncrowned  heroes  of  health." 

This  new  modern  era  of  preventive  medicine  has  not  only 
been  characterized  by  the  extraordinary  development  of  sani- 
tary engineering  and  other  methods  of  fighting  the  so-called 
"  filth  diseases,"  but  it  has  likewise  been  instrumental  in 
bringing  about  tremendous  advances  in  the  realms  of  personal 
hygiene,  industrial  hygiene,  and  other  phases  of  public  health 
improvement.  These  activities  have  reached  out  to  embrace 
such  matters  as  prevention  of  food  adulteration,  improvement 
of  both  water  and  milk  supply,  improved  plumbing  and 
sewage  disposal,  the  combating  of  flies,  dust,  and  other 
atmospheric  contamination,  the  improvement  of  sanitary  con- 


TRIUMPHS,  FAILURES  OF  MEDICINE  75 

ditions  in  both  workrooms  and  living  apartments,  not  to 
mention  the  tremendous  advances  in  the  sanitary  and  health 
management  of  the  early  years  of  child  life,  which  has  so 
enormously  cut  down  the  frightful  infant  mortality  of  fifty 
years  ago. 

Modern  hygienic  and  sanitary  teaching,  as  now  so  freely 
popularized  and  made  accessible  to  the  general  public,  has 
brought  us  the  knowledge  of  the  causation  of  the  majority 
of  ordinary  diseases,  has  pointed  out  the  method  of  their 
mastery,  and  also  designated  the  practical  steps  to  be  taken 
by  both  the  individual  and  the  public  as  a  whole,  in  order  to 
effect  their  speedy  and  complete  subjugation  as  menaces  to 
human  health  and  efficiency.  The  microscope  demonstrated 
the  cause  of  the  contagious  diseases,  and  the  development  of 
modetn  science  has  clearly  pointed  out  the  path  of  deliverance, 
and  we  have  every  reason  to  hope  that  in  the  near  future 
those  diseases  which  have  so  far  defied  all  scientific  efforts 
to  bring  about  their  overthrow  will  soon  have  their  microbic 
causes  disclosed  and  their  ultimate  remedies  or  methods  of 
attack  discovered  and  put  into  successful  operation. 

MASTERING  THE    MICROBE 

The  natural  normal  man  is  mightier  than  the  microbe. 
The  healthy  man  is  not  attractive  to  the  ordinary,  average 
disease  germ  —  unless  in  the  case  of  a  widespread  epi- 
demic, such  as  smallpox,  influenza,  pneumonia,  etc. ;  and 
so,  while  we  are  on  the  way  to  a  realization  of  the  fulfilment 
of  the  prophecy  that  "  it  is  within  the  power  of  man  to  drive 
all  microbic  diseases  from  the  face  of  the  earth,"  while  we 
are  succeeding  in  our  struggle  with  the  microbe  in  this 
gigantic  war  which  is  being  waged  between  .the  trained  forces 
of  science  on  the  one  hand  and  the  malignant  forces  of  dis- 
ease on  the  other;  nevertheless,  we  are  losing  out  in  our 
efforts  to  overcome  many  of  the  non-microbic  maladies. 


76  RACE  DECADENCE 

Disease  microbes  attack  men  when  they  are  already  sick, 
when  they  are  run  down  and  weakened  from  some  cause  or 
other,  for  the  very  same  reason  that  moss  grows  only  on  the 
shady  side  of  an  old  dead  or  dying  tree.  In  other  words, 
as  a  general  proposition,  you  have  got  to  get  sick  consti- 
tutionally before  you  take  sick  with  "  bugs  "  —  except  as  in 
the  case  of  the  epidemics  previously  mentioned. 

Typhoid  fever  has  about  departed.  I  get  vaccinated  every 
few  years,  and  I  don't  fear  the  disease,  even  if  somebody 
else  is  unclean  and  insanitary.  Vaccination  will  protect 
against  all  but  the  most  gross  infection,  but  of  course  this 
fact  should  not  cause  us  to  slacken  our  efforts  to  improve 
all  water  and  milk  supply,  as  regards  typhoid  infection. 

Our  soldiers  in  the  World  War  did  not  die  like  flies,  as 
they  did  in  the  South  during  the  Spanish-American  War, 
from'  typhoid  fever.  We  have  made  that  improvement  in 
the  work  of  preventing  typhoid  fever,  that  according  to  the 
latest  American  statistics,  the  typhoid-rate  throughout  the 
United  States  is  not  over  10  per  100,000.  This  would  sug- 
gest that  about  one-twentieth  of  our  population  may  expect 
to  have  typhoid  fever  at  sometime  during  life.  While  this 
is  a  great  improvement  over  conditions  as  they  were  twenty- 
five  or  thirty  years  ago,  it  is  not  at  all  satisfactory,  as  Great 
Britain  has  a  typhoid  death-rate  of  only  3.5  per  100,000, 
a  great  deal  less  than  half  of  our  rate.  We  not  only  ought 
to  reach  a  typhoid  mortality  rate  as  good  as  that  of  England, 
but  we  ought  not  to  stop  until  we  can  equal  that  of  Chicago, 
which  is  practically  only  one  death  per  100,000  of  popula- 
tion. In  fact  typhoid  has  become  so  rare  in  Chicago  that 
the  moment  a  physician  suspects  it,  he  immediately  asks  the 
patient  what  part  of  the  country,  outside  of  Chicago,  he 
came  from.  In  Chicago,  we  regard  typhoid  fever  as  a  "  coun- 
try "  disease.  The  "  old  oaken  bucket,  the  moss-covered 
bucket  that  hung  in  the  well,"  in  years  gone  by,  too  often 


TRIUMPHS,  FAILURES  OF  MEDICINE  77 

brought  up  the  deadly  bacilli  of  typhoid,  to  be  quaffed  by  the 
innocent  and  thirsty  patrons  of  the  well  in  which  it  hung. 

The  farmer  must  learn  three  things  about  typhoid  fever, 
in  order  to  lessen  the  country  death-rate.  First,  the  danger 
of  the  open  privy  vault;  second,  the  ease  of  infecting  the 
open  dug  well ;  and  third,  the  role  of  flies  as  typhoid  carriers 
infecting  milk  and  other  foodstuffs.  The  most  important 
thing  in  the  prevention  of  typhoid  fever  is  to  clean  up; 
discard  all  suspected  sources  of  drinking  water,  screen  the 
flies,  take  care  of  the  matter  of  sewage  in  a  satisfactory 
manner  and  having  done  all  this  to  prevent  the  disease,  it 
can  be  further  guarded  against  by  anti-typhoid  vaccine,  and 
by  treating  the  drinking  water  so  as  to  destroy  the  "  bugs." 

The  beneficial  results  of  modern  sanitation  have  been 
mo  ret  generally  enjoyed  by  the  larger  centers  of  population. 
The  big  cities  have  experienced  a  lowering  of  the  disease  and 
death-rates  to  a  greater  extent  than  has  been  enjoyed  by  the 
rural  communities ;  but  it  is  to  be  hoped  that  the  country 
districts  of  the  United  States  will  soon  catch  up  with  their 
city  cousins  in  the  good  work  of  sanitation  and  other  disease- 
preventive  procedures. 


One  hundred  or  two  hundred  years  ago  the  populations 
of  the  civilized  nations  were  periodically,  overrun  by  vari- 
ous plagues  and  epidemic  diseases.  These  scourges  were 
unrestrained  by  quarantine  and  sanitary  science,  and  while 
the  death-rate  was  appalling,  nevertheless,  to  the  race  as 
a  whole,  these  epidemic  plagues  served  a  more  or  less  use- 
ful purpose  —  they  served  to  weed  out  the  sickly,  the  feeble, 
and  the  less  desirable  members  of  society,  and  thus,  in- 
directly, they  contributed  much  to  keeping  the  stock 
vigorous  and  strong.  Today,  science  is  bringing  under  con- 
trol these  epidemic  methods  of  natural  selection,  and  is 


78  RACE  DECADENCE 

unintentionally  protecting  and  preserving  the  mentally  and 
physically  inferior  strains  of  the  race,  which  live  on,  inter- 
marry with  the  strong,  normal  stock  of  the  nation,  and  thus 
deteriorate  the  constitutional  stock  of  the  American  people 
from  generation  to  generation. 

The  public  health  movement  of  the  nineteenth  century 
was  a  wonderful  scientific  achievement,  but  it  is  serving  the 
purpose  of  weakening  the  nation,  as  a  whole.  We  do  not 
mean  to  belittle  the  blessings  which  sanitation  has  bestowed 
upon  the  race.  These  things  are  all  humanitarian,  not  to 
say  philanthropic,  but  considering  the  purely  physical  good 
of  future  generations,  they  will  prove,  in  the  end,  a  curse, 
if  we  do  not  inaugurate  hand  in  hand  with  public  hygiene, 
an  intelligent  and  effectual  propaganda  of  personal  and  race 
hygiene.  The  hygienic  care  of  the  health  of  the  individual  on 
the  one  hand,  and  the  eugenic  safeguarding  of  the  mental 
stamina  of  the  offspring  of  the  next  generation,  on  the 
other  hand,  are  all  part  of  the  efforts  that  must  be  made 
to  counteract  the  annulment  of  the  laws  of  natural  selec- 
tion by  modern  sanitary  science  and  other  public  health 
activities. 

During  the  last  hundred  years  bubonic  plague  (black 
death),  Asiatic  cholera,  typhus  fever,  leprosy,  smallpox, 
yellow  fever,  malaria,  diphtheria,  eye  infections  (trachoma), 
and  numerous  infantile  diseases  which  in  past  centuries  swept 
over  the  civilized  nations  from  time  to  time  as  devastating 
scourges,  have  all  been  either  wiped  out  or  else  subdued 
to  that  point  where  they  no  longer  menace  civilized  society: 

Tuberculosis  and  venereal  diseases  —  together  with  in- 
fluenza and  pneumonia  —  are  not  yet  in  subjection;  they  are 
only  the  exceptions  which  serve  to  prove  the  rule  of  the 
certain  and  successful  overthrow  of  the  plague  terrors  of 
the  ancient  world. 

No  longer  do  we  fear  the  invasion  of  our  country  by  these 


TRIUMPHS,  FAILURES  OF  MEDICINE  79 

devastating  maladies.  Vaccinations  against  smallpox  would 
wipe  it  out  in  a  single  generation  if  universally  practiced. 
Yellow  fever  has  left  our  shores  if,  indeed,  it  has  not  been 
driven  off  the  face  of  the  earth  —  having  made  its  last  stand 
in  Ecuador.  The  final  overthrow  of  malaria  only  awaits 
the  intelligent  application  of  the  known  laws  of  anti-mosquito 
breeding  and  the  judicious  use  of  quinine  in  the  case  of  those 
persons  already  infected.  The  preventive  and  curative  use 
of  antitoxin  would  soon  serve  to  vanquish  what  remains  of 
the  terror  of  diphtheria.  There  are  certain  disorders  which 
remain  more  or  less  unconquered  —  dealt  with  more  fully  in 
subsequent  chapters. 

ADVANCES    IN     MILITARY    MEDICINE 

In  fco  other  department  of  medicine  (unless  it  be  in  the 
recent  achievements  in  lessening  the  infantile  death-rate)  does 
the  work  of  modern  preventive  medicine  cover  itself  with  such 
glory,  when  it  comes  to  preventing  disease  and  lessening 
mortality,  as  is  shown  in  the  achievements  of  the  medical 
departments  of  the  armies  of  the  nations  engaged  in  the 
recent  World  War.  Outside  of  the  one  failure/which  stands 
out  so  conspicuously  —  that  of  the  influenza  epidemic  and  its 
associated  pneumonia  —  the  deaths  from  preventive  disease 
in  the  army  were  almost  negligible. 

In  the  first  place,  our  old  military  friends,  typhus  fever, 
Asiatic  cholera,  etc.,  did  not  even  put  in  an  appearance,  and 
from  September  i,  1917,  to  May  2,  1919,  with  an  average 
muster  roll  of  over  2,000,000  soldiers,  only  5  men  died  from 
smallpox,  only  213  from  typhoid  fever,  and  the  old  plague 
of  malaria  hardly  appeared,  only  13  deaths  being  recorded. 

Of  course,  there  occurred  unfortunately,  during  the  time 
of  our  recent  military  mobilization,  a  veritable  plague  of 
influenza  associated  with  pneumonia,  and  this  with  its  vari- 
ous complications  —  pleurisy,  empyema,  etc.,  carried  off 


8o 


RACE  DECADENCE 


41,747  soldiers,  emphasizing  most  emphatically  that  in  the 
presence  of  the  triumphs  of  military  preventive  medicine, 
there  are  certain  phases  and  features  of  disease  which  we 
have  done  little  or  nothing  to  prevent,  control,  or  combat. 

A  study  of  the  following  table,  which  compares  the  deaths 
in  the  army  during  the  recent  World  War,  and  showing 
what,  with  the  same  sized  army,  the  deaths  from  these  vari- 
ous diseases  would  have  been,  both  in  the  Spanish- American 
and  in  the  Civil  War  days,  is  one  way  of  graphically  empha- 
sizing and  showing  the  great  advances  of  preventive  medi- 
cine, as  regards  the  health  of  an  army. 

SOME  INTERESTING  FACTS  CONCERNING  THE  DEATHS  IN  THE  U.  S. 
ARMY  (Including  the  A.  E.  F.)  FROM  DISEASE  DURING  THE  WORLD  WAR 


Number  of   deaths 

Number  of  deaths 

Number  of  deaths 

that  occurred  in 

that  would  have 

that  would  have 

World  War,  Sept. 

occurred    if    the 

occurred    if    the 

DISEASE 

1,  1917—  May  2, 

Civil  War  death- 

Spanish-  Amer- 

1919.    Average 

rate   had    ob- 

ican War   deat  li- 

approximately 2,- 

tained. 

ra  te    had   ob- 

121.396. 

tained. 

213 

51,133 

68  164 

13 

13,951 

11,317 

Dysentery  

42 

63,898 

6,382 

5 

9,536 

37 

41,747 

38,962 

6  086 

Scarlet  fever  

167 

112 

222 

100 

1,183 

149 

1,220 

9,574 

631 

Meningitis  

2,137 

3,859 

4,081 

3,768 

34,881 

15,587 

Total 

49,412 

227,094 

112,656 

THE  TRIUMPHS  OF   SURGERY 

The  modern  surgeon  undertakes  to  do  almost  anything  in 
the  line  of  anatomical  carpentry,  cabinet-making,  and  plumb- 
ing, as  regards  the  human  machine.  Surgeons  operate  on 
joints  without  hesitation;  they  go  into  the  chest  cavity  and 
operate  upon  heart  and  lungs ;  they  work  skilfully  upon  the 
delicate  structure  of  the  brain  —  in  fact  there  is  only  about 
one  triumph  left  for  surgery  to  master,  and  that  is  the  trans- 
planting of  vital  organs ;  that  is  —  the  ability  to  take  a  kidney, 


TRIUMPHS,  FAILURES  OF  MEDICINE  8 1 

for  instance,  out  of  some  unfortunate  individual  who  has 
been  killed  by  an  accident,  and  put  it  into  the  body  of  a 
man  who  has  been  living  too  swiftly  —  who  has  Bright's 
disease.  While  this  has  been  done  only  in  exceptional  cases 
in  human  beings  (a  few  cases  in  which  the  sex  glands  have 
been  temporarily  transplanted)  it  has  been  done  successfully 
in  the  case  of  lower  animals.  Cat's  kidneys  and  sheep's  kid- 
neys have  been  put  into  cold  storage  and  later  put  into  the 
body  of  a  dog,  and  the  dog  has  lived. 

This  probability  of  transplanting  vital  organs  suggests  a 
strange  possible  situation  in  future  times,  in  which  the  well- 
to-do  citizen  with  a  crippled  kidney  may  seek  to  take  out 
a  mortgage  on  the  kidney  of  some  less  prosperous  fellow, 
in  case  he  of  the  good  kidney  should  suddenly  shuffle  off  from 
some  accident,  whereupon  he  of  the  bad  kidney  would  hie 
himsefe  to  a  hospital  —  go  to  sleep  for  an  hour  —  and  come 
out  with  a  pair  of  kidneys  almost  as  good  as  new. 

We  tell  such  stories  as  these  in  a  jocular  spirit  at  the  pres- 
ent time,  but  they  are  not  beyond  the  pale  of  possibility  in 
the  not  far  distant  future.  Science  is  achieving  many  things 
once  thought  impossible. 

FAILURES  OF  PREVENTIVE   MEDICINE 

While  it  is  both  encouraging  and  refreshing  to  record  and 
recount  the  developments  of  modern  sanitary  science  and  the 
achievements  of  our  more  recent  efforts  along  the  lines  of 
preventive  medicine;  nevertheless,  it  is  more  fitting  just  now, 
and  will  be  more  productive  of  increased  efforts  looking 
toward  health  improvement  and  race  betterment,  if  we  will 
frankly  and  honestly  sit  down  together  and  face  the  facts  — 
sincerely  recognize  wherein  we  are  failing  to  stem  the  tide 
of  disease  and  death. 

We  have  already  frankly  admitted  that  among  the  germ 
diseases,  we  have  failed  almost  completely  in  our  efforts  to 


INCREASES  AND  DECREASES  FROM  CERTAIN 
DISEASES 

(Employed  Males) 

DEATH-RATE  PER  100,000        INCREASE  AND  DECREASE 

IN  10  YEARS 


The  same  story  of  the  declining  power  of  the  Ameri- 
can people  to  resist  diseases  of  the  vital  organs  is  told 
by  the  statistics  in  the  general  population  wherever 
comparisons  can  be  had. 


Fig.  5.     Graphic  illustrating  the  increased  and  the  decreased 
death-rates  of  certain  common  diseases 


TRIUMPHS,  FAILURES  OF  MEDICINE  83 

understand  and  control  both  influenza  and  pneumonia,  while 
at  the  same  time  we  are  making  an  equally  sad  failure  of 
our  methods  of  controlling  venereal  disorders,  although  we 
are  fully  cognizant  of  their  causes  and  know  how  to  prevent, 
suppress,  and  control  them;  but,  as  has  been  intimated, 
these  diseases,  comprising  the  "  great  black  plague "  will 
be  more  fully  considered  in  a  later  chapter. 

Men  of  science  and  medicine  have  not  only  failed  to 
improve  the  situation  and  lessen  the  death-rate  from  the 
so-called  "  habit  disorders  "  or  "  old-age  "  diseases,  but  these 
diseases  are  actually  increasing  by  leaps  and  bounds  —  in 
the  very  presence  of  our  splendid  achievements  in  the  other 
domains  of  preventive  medicine.  Kidney  diseases,  heart 
disorders,  diseases  of  the  blood  vessels  (arteriosclerosis) 
with*their  consequent  afflictions  of  apoplexy  and  paralysis 
have  increased  to  an  alarming  degree  during  the  last  gen- 
eration. 

These  commonly  called  "  degenerative  disorders  "  are  all 
quite  fully  understood,  as  regards  their  causation,  but  since 
they  are  not  any  of  them  directly  germ-caused  diseases,  the 
great  advances  of  sanitary  science  have  not  in  any  way 
touched  upon,  or  led  in  the  least  to  improvement,  as  regards 
their  prevalence  and  the  enormous  premature  death-rate 
resulting  therefrom.  This  phase  of  the  discussion  will  also 
be  more  fully  dealt  with  in  subsequent  chapters,  and  is 
enumerated  here  merely  to  complete  the  picture  of  those  dis- 
eases which  comprise  the  great  failure  of  modern  preventive 
medicine,  owing  to  the  fact  that  it  has  overemphasized  sani- 
tary science  and  failed  to  promote  the  cause  of  personal 
hygiene  in  a  corresponding  degree.  (See  Fig.  5.) 

While  we  are,  apparently,  increasing  the  average  length 
of  life,  and  have  almost  accomplished  the  overthrow  of  the 
"  filth  diseases,"  we  are  permitting  the  civilized  nations  to 
go  right  along  committing  suicide  on  the  instalment  plan 


£4  RACE  DECADENCE 

through  our  failure  to  check  the  increase  of  these  numerous 
"  degenerative  diseases  "  —  the  habit-caused  disorders. 

Very  few  insurance  companies  will  now  write  a  policy 
without  knowing  the  applicant's  blood-pressure.  While  low 
blood-pressure  is  of  serious  concern  in  many  forms  of  heart 
trouble,  nervous  exhaustion,  etc.,  nevertheless,  the  thing  that 
attracts  most  attention  in  the  average  apparently  healthy 
individual  is  the  frequent  prevalence  of  high  blood-pressure. 
High  blood-pressure  is  largely  a  matter  of  personal  habits 
of  living,  thinking,  working,  resting,  etc.,  and  is  only  in- 
directly connected  with  microbic  disorders. 

From  whatever  causes  due,  various  liver,  digestive,  and 
intestinal  disorders  are  certainly  not  on  the  decrease,  and 
according  to  available  statistics  many  of  these  diseases  seem 
to  be  definitely  on  the  increase ;  no't  to  mention  such  constitu- 
tional and  systemic  ailments  as  diabetes,  which  is  also 
increasing  —  and  increasing  at  an  alarming  pace. 

THE  HEALTH   STRUGGLE  OF  THE  FUTURE 

The  future  health  propaganda,  while  perhaps  not  dealing 
any  less  with  sanitary  science  and  public  health  measures 
than  in  the  past,  must  pay  more  attention  to  personal 
hygiene.  The  role  of  inheritance  in  race  improvement  must 
receive  more  consideration.  We  must  also  take  up  such  prob- 
lems as  the  cause  and  cure  of  cancer.  As  will  be  shown 
more  fully  presently,  cancer  is  a  standing  menace  which  chal- 
lenges the  entire  medical  profession  and  the  scientific  world, 
to  discover  its  cause  and  develop  methods  of  combat  and 
cure. 

Even  such  a  commonplace  problem  as  acute  and  chronic 
colds  remains  to  be  solved.  We  have  made  astonishingly  slow 
progress  in  the  development  of  methods  to  prevent,  or 
alleviate,  this  ordinary,  everyday  harassment. 

The  proper  place  to  begin  this  new  health  propaganda  of 


TRIUMPHS,  FAILURES  OF  MEDICINE  85 

hygiene  is  in  the  public  schools ;  not  only  in  instructing  the 
children,  but  in  a  brand-new  teaching  of  physiology,  hygiene, 
and  eugenics,  which  shall  begin  in  the  early  grades  and  fol- 
low the  pupil  throughout  his  educational  career  —  to  the 
finish  of  high  school  —  and  then  into  college.  In  this  way 
the  children  can  be  taught  the  importance  of  both  periodic 
dental  and  medical  examinations,  and  will  be  able  to  carry 
this  hygienic  and  eugenic  teaching  home,  with  a  view  of 
also  affording  some  little  help  to  the  passing  generation. 
Personal  hygiene  and  improved  heredity  is  tlie  keynote  to 
the  health  teaching  of  the  coming  generation,  and  all  our  past 
achievements  will  not  serve  to  stay  the  tide  of  increasing  dis- 
ease or  to  bring  about  an  improvement  in  the  death-rate  from 
these  "  habit  disorders,"  until  we,  as  a  nation,  have  passed 
through  the  experience  and  enjoy  the  benefits  of  a  real 
hygienic  and  eugenic  revival. 

TOKENS  OF  THE  DAWN 

Having,  in  this  chapter,  briefly  portrayed  the  triumphs  of 
modern  medical  and  sanitary  science,  and  having  also  frankly 
pointed  out  some  of  our  humiliating  failures  to  improve 
human  health  and  lessen  the  death-rate  from  certain  groups 
of  physical  disorders,  it  may  not  be  amiss,  in  ending  the  chap- 
ter, briefly  to  survey  some  of  the  encouraging  omens,  to  point 
out  the  tokens  of  the  dawning  of  a  new  era  —  of  a  better 
day  —  which  promises  to  correct  the  mistakes  of  the  past  and 
to  fulfill,  at  least  to  some  degree,  our  high  hopes  of  the 
future.  These  indications  of  the  awakening  of  the  health 
consciousness  of  the  American  people  are  shown  by  the  recent 
organization  of  numerous  societies  devoted  to  the  study  of 
various  problems  and  diseases,  such  as  the  societies  for  the 
study  and  prevention  of  cancer,  tuberculosis,  venereal  dis- 
eases, feeble-mindedness,  etc.  Still  further  evidence  of  this 
awakening  along  health  lines  is  presented  by  our  many  activi- 


86  RACE  DECADENCE 

ties  directed  toward  enlightening  the  public  regarding  health 
and  hygiene  among  which  may  be  mentioned  the  following : 

1.  Increased  efficiency  —  in  public  health  administration, 
including  the  agitation  for  better  registration  of  births  and 
deaths.     The  increasing  efficiency  of  the  health  departments 
of  towns,  cities,  and  states.    Improved  industrial  health  move- 
ments —  industrial  health  insurance,  etc. 

2.  Health  literature  —  newspapers  and  magazines,  not  to 
mention  the  great  number  of  books  for  the  layman,  good 
books  too,  which  have  appeared  and  are  now  appearing. 
Almost  every  paper  of  any  consequence  in  this  country  has 
a  regular  health  department,  as  a  rule,  supervised  by  a  com- 
petent medical  authority. 

3.  Industrial  medical  supervision  —  factories,  manufactur- 
ing establishments,  not  only  the  large  ones  but  even  some  of 
the  smaller  ones,  have  their  institutional  physicians  and  a 
more  or  less  well-regulated  system  of  supervising  the  health 
and  efficiency  of  their  employees. 

4.  Insurance  supervision. —  A   few  insurance   companies' 
are  trying  to  provide  annual  supervision  for  their  policyhold- 
ers.    I  sometimes  think  that  the  health  movement  —  like  the 
temperance  cause  —  will  achieve  no  great  success  until  it 
gets  on  a  practical  commercial  basis.     The  insurance  com- 
panies can  save  money  by  keeping  their  policyholders  alive, 
and  so  they  are  therefore  doing  a  great  deal  to  foster  and 
father  this  new  movement  of  preventive  medicine. 

5.  Infant  welfare. —  One  of  the  great  causes  of  lessened 
mortality,  and  of  apparent  increase  in  the  average  length  of 
life,  as  has  already  been  noted,  is  the  great  improvement  in 
infant  care —  in  the  prevention  of  the  diseases  of  the  earlier 
years  of  the  child's  life.    Pure  milk  stations,  mother's  clinics, 
infant  welfare  movement,  the  whole  nation-wide  propaganda 
for  saving  the  babies,  has  produced  definite  results,  even 
though  the  eugenist  may  question  these  results. 


TRIUMPHS,  FAILURES  OF  MEDICINE  87 

6.  School  inspection. —  The  improvement  and  extension  of 
our  medical  inspection  of  schools,  with  the  general  improve- 
ment of  school  hygiene,  whether  in  the  matter  of  exercise, 
athletics,  and  free,  or  penny  lunches,  have  all  contributed 
something  to  maintaining  the  resistance  of  our  youth  against 
disease. 

7.  Simple  living. —  There  is  a  growing  popularity  of  what 
might  be  called  the  simple  life  or  the  "  back-to-nature  "  move- 
ment.   The  vast  majority  of  intelligent  people  of  the  younger 
generation  ventilate  their  bedrooms.    The  old-fashioned  dark, 
damp,  clammy,  spare  bedroom  is  passing  out  of  existence. 
Personal  hygiene  in  all  classes  has  improved  100  per  cent  in 
the  past  ten  years.     There  is  vast  improvement  in  those 
phases  of  sanitation  and  hygiene,  even  if  our  dress  is  not 
altogether  what  it  should  be. 

8.  Improved  hygienic  teaching. —  The  educational  institu- 
tions of  the  land,  colleges  and  high  schools,  are  giving  more 
attention  to  hygiene.    The  mania  for  outdoor  living  has  been 
augmented  by  the  automobile.     Outdoor  athletics  are  still 
popular,  and  physical  culture  has  become  almost  a  fad  with 
some  enthusiasts.     Associated  with  this  revival  in  outdoor 
living,  are  to  be  found  those  who  advocate  the  movement 
of  "  back  to  the  land,"  and  who  are  advocating  the  suburban 
method  of  living  for  some  of  our  city  dwellers.    The  tendency 
of  the  American  citizen  to  breathe  fresh  air,  and  to  work  and 
sleep  in  the  open  as  much  as  possible,  has  become  almost 
characteristic  of  our  citizenry. 

9.  Moral  advancement. —  The  sex  educational  propaganda, 
together  with  the  movement  which   has   declared  war  on 
venereal  diseases,  is  a  hopeful  sign  for  the  earlier  years  of  the 
twentieth  century.  The  anti-race-suicide  propaganda,  and  the 
mutterings  against  the  professional  abortionist,  all  point  to  a 
further  awakening  of  our  health  and  eugenic  consciousness 
which  promises  good  for  the  near  future. 


88  RACE  DECADENCE 

10.  Improved  dietetic  Iwbits. —  The  pure  food  legislation, 
together  with  a  more  general  dissemination  of  dietetic  knowl- 
edge, has  been  a  great  help  in  the  last  few  years.    The  United 
States  Food  Administration,  during  the  war,  did  a  tremendous 
amount  of  good  by  its  dissemination  of  a  better  understand- 
ing of    foodstuffs  and   dietetics  in  general.    The  average 
American  of  this  generation  knows  more  about  foods  than 
did  his  parents  and  grandparents. 

11.  Supervision  by  the  family  physician. —  A  great  many 
people  are  forming  the  habit  of  going  to  their  doctors  once  or 
twice  a  year  just  like  they  do  to  their  dentists,  to  be  looked 
over;  and  although  in  many  cases  this  work  may  not  be 
as  thorough  as  might  be  desired,  yet  it  is  of  great  value  — 
even  as  in  the  case  of  those  laboratories  which  are  examining 
the  urine  once  a  year.    These  superficial  examinations  serve 
a  valuable  purpose,  although  we  have  seen  many  patients  with 
blood-pressure  over  200  who  supposed  they  were  in  fine  con- 
dition because  these  periodical  urine  analyses  had  been  for  a 
long  time  showing  up  apparently  normal.    In  this  connection 
repeated  blood-pressure  observations  are  far  more  important 
in  the  early  detection  of  degenerative  disorders  than  are  these 
frequent  examinations  of  the  urine. 

12.  Annual  health  supervision. —  Institutions  and  groups 
of  physicians  are  now,  in  different  cities,  associating  them- 
selves for  the  purpose  of  giving  annual  health  service.    This 
service  is  probably  going  to  work  out  on  the  same  lines  fol- 
lowed by  the  legal  fraternity.    You  pay  an  annual  retaining 
fee  for  the  supervision  of  your  own  health  or  that  of  your 
family  with  a  schedule  of  slight  additions  thereto  arranged  to 
become  operative  in  case  of  acute  or  prolonged  illness  which 
cannot  otherwise  be  prevented. 

Strange  that  we  show  so  much  system  in  the  management 
of  our  legal  affairs  and  manifest  such  poor  judgment  in  the 
management  of  our  health  problems.  What  business  man 


TRIUMPHS,  FAILURES  OF  MEDICINE  89 

would  think  of  managing  his  legal  department  on  a  plan  of 
ringing  up  an  attorney  any  time  anything  happened.  Not  at 
all.  You  retain  good  legal  counsel  by  the  year.  You  pay  your 
lawyer  for  keeping  you  out  of  litigation,  as  well  as  to  win 
your  case  for  you  when  trouble  does  come.  Some  day  you 
may  pay  your  doctor  to  keep  you  out  of  disease  —  you  may 
pay  him  by  the  year  —  and  then,  just  as  in  the  case  of  youu 
attorney,  if  disease  cannot  be  avoided,  you  will  then  pay  him 
some  additional  fee  for  this  special  service  when  rendered. 

13.  Modern  health  audit  organisations. —  Perhaps  the  most 
recent  development  in  the  conservation  of  health,  is  the  or- 
ganization in  the  larger  cities  of  semi-philanthropic,  or  self- 
supporting  institutions  for  promulgating  and  practicing  the 
idea  of  the  annual  health  audit.    The  bringing  into  existence 
of  tfiese  organizations  with  their  unusual  facilities,  designed 
for  the  thoroughgoing  investigation  of  well  people,  marks  a 
new  era  in  the  cause  of  preventive  medicine.    Heretofore 
thorough  research  examinations  embracing  the  entire  body 
and  its  many  special  organs,  could  only  be  had  by  going  to 
some  large  hospital  or  sanitarium,  or  by  the  patronage  of  a 
large  number  of  specialists  which  was  both  inconvenient  and 
highly  expensive.    It  is  strange  indeed  that  we  have  been  so 
slow  to  recognize  these  needs  and  properly  provide  for  them, 
but  the  demand  which  has  recently  sprung  up  as  the  result 
of  the  education  of  the  public  along  these  lines,  will  soon  be 
met   by  proper  organization  on   the   part  of   the   medical 
profession. 

14.  Eugenic  investigations. —  Last,  but  not  least,  among 
the  encouraging  signs  of  the  times  pointing  toward  race  bet- 
terment,  should  be  mentioned   the   great   advancement   in 
eugenics  during  the  last  dozen  years.    The  science  of  heredity 
has  made  wonderful  progress  since  the  dawn  of  the  twentieth 
century.    The  laws  of  human  inheritance  in  relation  to  "  race 
decadence  "  have  been  discovered  and  developed  enormously 


90  RACE  DECADENCE 

during  the  last  decade.  Heredity  promises  to  rival  hygiene  in 
this  work  of  race  improvement,  and  in  the  future,  eugenics 
must  find  a  place  in  all  our  plans  to  combat  human  disease 
and  race  degeneracy. 

SUMMARY  OF  THE  CHAPTER 

1.  The  science  of  sanitation  goes  back  to  the  dawn  of  his- 
tory —  back  to  Egypt,  Greece,  and  Rome. 

2.  The  ancient   Hebrews  constructed   elaborate   sanitary 
works  and  provided  a  pure  water  supply  for  Jerusalem. 

3.  Hippocrates  advocated  boiling  and  filtering  all  drink- 
ing water. 

4.  Almost  a  thousand  years  before  Christ,  Athens  had  a 
water  system  and  Rome  a  sewer  system. 

5.  The  dawn  of  modern  medicine  and  sanitation  dates  from 
the  discovery  of  the  microscope  and  the  subsequent  birth  and 
development  of  the  science  of  bacteriology. 

6.  Present-day  preventive  medicine  is  devoted  to  discover- 
ing the  causes  of  disease ;  to  educating  the  public  regarding 
sanitation;  and  to  scientific  efforts  to  prolong  life. 

7.  In  the  past,  our  health  efforts  have  been  devoted  to  mas- 
tering the  microbe  —  in  the  future  —  we  must  pay  more 
attention  to  personal  hygiene. 

8.  Typhoid    fever   is   a   "  filth    disease "    which    sanitary 
science  and  vaccination  is  slowly  driving  —  in  common  with 
numerous  other  microbic  diseases  —  from  the  face  of  the 
earth. 

9.  Even  today  we  have  a  typhoid  fever  death-rate  that  is 
twice  that  of  Great  Britain.     Chicago  has  a  typhoid  death- 
rate  of  only  one  person  per  100,000. 

10.  The  American  farmer  has  yet  to  learn  the  role  of 
privy  vaults,  open  wells,  and  flies  in  the  cause  and  spread  of 
typhoid. 

1 1 .  In  olden  times  the  plagues  used  to  weed  out  the  weak 
and  sickly,  and  thus  served  —  through  the  operation  of  the 
law  of  natural  selection  —  to  keep  the  race  more  vigorous. 

12.  Today,  science  protects  the  weak  and  feeble  —  keeps 
them  alive  to  reproduce  large  numbers  of  their  inferior  kind 
to  curse  future  generations. 


TRIUMPHS,  FAILURES  OF  MEDICINE  91 

13.  The  hygienic  care  of  the  present  generation  sometimes 
seems  counter-wise  to  the  eugenic  protection  of  the  strength 
and  stamina  of  future  generations. 

14.  Asiatic  cholera,   black  death,  yellow   fever,  malaria, 
diphtheria,  and  smallpox  have  been  practically  wiped  out  as 
devastating  world  plagues. 

15.  Of  all  the  terrible  world  plagues  only  tuberculosis,  in- 
fluenza, and  venereal  diseases  fail  of  having  been  brought 
under  more  or  less  complete  control. 

1 6.  In  military  medicine  great  advances  have  been  made. 
In  almost  two  years  with  over  2,000,000  soldiers,  we  lost  only 
5  from  smallpox  and  only  213  from  typhoid. 

17.  The  greatest  death-rate  in  recent  years  from  the  old 
plagues  has  occurred  in  connection  with  the  unmastered  influ- 
enza epidemics  and  the  associated  pneumonia. 

1 8.  If  the  typhoid  death-rate  of  the  Spanish- American  War 
had  obtained  during  the  recent  World  War,  we  should  have 
lost  lover  51,000  soldiers  from  that  cause  alone. 

19.  The  greatest  triumphs  of  curative  medicine  have  been 
along  surgical  lines.     Today  the  surgeon  does  about  every- 
thing short  of  transplanting  the  vital  organs. 

20.  The  mistakes  of  preventive  medicine  are  shown  in  its 
failure  to  lower  the  death-rate  for  the  "  habit  diseases  "  — 
heart  failure,  kidney  and  arterial  disorders. 

21.  The  health  struggle  of  the  future  must  be  more  de- 
voted to  the  mastery  of  these  so-called  "  degenerative  dis- 
orders "  by  which  so  many  men  and  women  commit  suicide. 

22.  Personal  hygiene  must  become  the  keynote   of   the 
health  teaching  of  the  coming  generation. 

23.  We  observe  the  tokens  of  the  dawn  of  better  times  in 
the  general  health  awakening  of  the  American  people;  in 
the  rapid  spread  of  hygienic  information ;  in  the  increased 
medical  supervision  of  school  children;  and  the  rapid  ad- 
vancement of  various  methods  of  disease-control. 

24.  The  one  thing  needful  today,  is  the  further  spread  of 
the  practice  of  having  an  annual  medical  examination  — 
just  as  the  dentist  is  consulted  periodically. 

25.  Among  those  new  developments  which  promise  help 
for  the  cause  of  race  improvement  is  the  new  science  of  eu- 
genics. 


CHAPTER  VI 
THE  CANCER  PROBLEM 

CANCER  is  indeed  a  plague.    So  far  this  dread  disease 
has  baffled  science.    The  cause  has  not  been  discovered 
—  neither  has  the  remedy  —  except  as  regards  a  resort  to 
surgical  removal  at  such  time  as  permits  the  complete  extir- 
pation of  all  malignant  growth  and  involved  tissue. 

IS  CANCER  INCREASING? 

Cancer  appears  to  be  on  the  increase  in  every  civilized 
country.  The  death-rate  in  the  United  States  registration 
area  increased  from  63  per  100,000  population  in  1900  to 
81.6  in  1917.  The  rise  in  the  recorded  cancer  death-rate  is, 
no  doubt,  partly  to  be  attributed  to  improved  medical  diagno- 
sis and  better  statistical  methods,  but  these  factors  seem  in- 
sufficient to  account  for  the  widespread  increase  reported 
from  practically  all  civilized  countries,  or  for  certain  signifi- 
cant variations  when  the  rates  are  studied  for  particular 
organs  by  age  and  sex  and  by  different  areas  and  countries. 
On  the  whole  cancer  is  probably  increasing,  though  not 
equally  with  all  forms  of  the  disease,  some  of  which  even 
show  a  slight  decrease. 

Cancer  causes  one  out  of  every  10  deaths  after  the  age  of 
40  in  this  country.  From  the  reports  of  the  United  States 
Census  Bureau  it  also  appears  that  cancer  causes  one  out  of 
every  8  deaths  among  women  of  40  and  over,  and  about 
one  in  every  13  deaths  among  men  of  the  same  age.  Among 
people  over  40  cancer  is  much  more  frequent  than  tuberculo- 
sis or  pneumonia. 

92 


THE  CANCER  PROBLEM  93 

Ninety-five  per  cent  of  all  deaths  from  cancer  occur  after 
35,  but  even  including  all  ages  and  both  sexes  cancer 
stands  among  the  half-dozen  chief  causes  of  death  such  as 
pneumonia,  heart  disease,  tuberculosis,  and  diseases  of  the 
kidney,  while  far  exceeding  in  its  annual  toll  many  common 
diseases  like  typhoid  fever,  diphtheria,  scarlet  fever,  measles, 
etc.  It  is  estimated  that  by  1922  the  cancer  mortality  for 
the  whole  country  will  be  100,000  or  over. 

Cancer  has  apparently  increased  300  per  cent  in  Boston  in 
thirty  years. 

In  1917  in  the  United  States  registration  area  tuberculosis 
claimed  110,285  deaths;  pneumonia,  112,821  (in  a  normal 
year  not  affected  by  the  influenza  epidemic) ;  heart  disease, 
115,337;  disease  of  the  kidneys,  80,912;  cancer  about  90,000 
—  this  ranking  among  the  leading  causes  of  death. 

THE  PREVALENCE  OF  CANCER 

Cancer  is  almost  exclusively  a  disease  of  adult  life. 
Largely  because  of  neglect  and  ignorance,  9  cases  out  of  10 
are  now  fatal.  Yet,  if  proper  precautions  and  treatment 
were  observed  in  the  early  stages  it  is  probable  that  over 
half  the  100,000  yearly  deaths  which  this  disease  now  causes 
in  the  United  States  could  be  prevented. 

Cancer  occurs  in  a  variety  of  forms  affecting  practically 
every  organ  or  part  of  the  body.  The  United  States  census 
report  shows  that  cancers  of  the  stomach  and  cancers  of  the 
liver  together  account  for  35,000  out  of  90,000  annual  deaths 
from  this  disease.  Cancer  of  the  female  generative  organs 
causes  13,000  deaths  per  annum,  cancer  of  the  breast  about 
8,500,  cancers  of  the  mouth  and  tongue  about  3,500,  cancers 
of  the  intestines  and  rectum  12,000,  cancers  of  the  skin  about 
3,500,  and  cancers  of  all  other  organs  and  parts  about 
14,500.  Probably  60  per  cent  of  cancers  of  the  rectum  are 
first  regarded  as  "  piles."  Insist  on  a  thorough  examina- 


per 
IOO.OOO 

of 
Population 


Fig.  6.     Showing  deaths  from  different  forms  of  cancer 


THE  CANCER  PROBLEM  95 

tion  of  all  rectal  troubles  and  have  all  chronic  and  trouble- 
some cases  of  "  piles  "  (hemorrhoids)  removed  by  surgical 
operation  before  they  degenerate  into  cancer.  (See  Fig.  6.) 

ESTIMATED  ANNUAL  MORTALITY   FROM    CANCER 
IN  CONTINENTAL  UNITED  STATES 

Organs  or  Parts                                 Males  Females  Total 

Buccal  cavity   2,725  570  3,295 

Stomach  and  liver 15,787  15,056  30,843 

Peritoneum,  intestines,  rectum 4,544  6,027  10,571 

Female  generative  organs 1 1,965  1 1,965 

Female  breast 7,77i  7,771 

Skin  1,982  1,098  3,080 

Others  7,838  4,637  12,475 


All  forms   32,876        47,124        80,000 

Thl  recorded  mortality  for  cancer  in  this,  as  in  other 
countries  of  the  world,  is  gradually  on  the  increase.  The 
annual  increase  in  the  cancer  death-rate  is  approximately  2.5 
per  cent.  The  recorded  cancer  death-rate  has  practically 
doubled  during  the  last  forty  years. 

CANCER  IN  CHICAGO 

Cancer  deaths  are  increasing  in  Chicago,  as  indicated  by 
the  mortality  figures  (given  below)  for  the  five-year  period, 
1914  to  1918,  inclusive. 

1914  2,091 

1915  2,078 

1916  2,254 

1917  2,256 

1918  2,407 


Total   11,086 

The  above  table  shows  that  while  deaths  from  cancer  are 
increasing  in  Chicago,  yet  the  emphatic  rise  in  the  death-rate 
from  this  cause  is  shown  in  the  figures  for  the  year  1918,  as 


96  RACE  DECADENCE 

compared  with  those  of  the  previous  year.  For  the  period 
named,  1914  to  1918  inclusive,  there  were  16,711  deaths  in 
Chicago  from  pulmonary  tuberculosis,  the  disease  with  which 
cancer  as  a  tolltaker  of  human  lives  has  already  been  com- 
pared. In  other  words,  the  "  Great  White  Plague,"  so 
called,  caused  only  5,685  more  deaths  in  five  years  than  were 
chargeable  to  cancer. 

PREVENTING  CANCER  DEATHS 

But  despite  the  alarming  increase  in  deaths  from  cancer, 
there  is  this  message  of  hope  sent  out  by  the  medical  and 
surgical  experts  who  have  studied  the  disease  in  all  its 
forms.  This  message  is  to  the  effect  that  cancer  is  a  curable 
disease  and  that  fully  60  per  cent  of  the  90,000  yearly  deaths 
in  this  country  are  needless  and  preventable. 

Medical  men  know  a  great  deal  more  about  cancer  today 
than  was  known  twenty  years  ago.  For  example,  it  is 
known  that  cancer  is  at  first  a  local  disease  and  not  a  constitu- 
tional, or  blood  disease.  It  begins  in  one  spot  as  a  small 
growth  which  in  the  early  stages  can  be  removed.  And  if 
this  is  done  promptly  by  a  competent  surgeon,  every  trace 
of  the  disease  can  often  be  eradicated  and  a  complete  cure 
effected.  But  if  neglected,  cancer  spreads  rapidly  and,  like 
a  fire  not  taken  in  time,  soon  gets  beyond  control. 

So  it  is  evident  that  early  diagnosis  and  treatment  are  the 
important  things  in  the  prevention  of  cancer  and  in  the  re- 
duction of  deaths  from  this  cause.  This  means  that  in  all 
cases  of  suspected  cancer,  medical  advice  should  be  sought  at 
once.  Delay  is  dangerous.  A  sore  on  any  part  of  the  body, 
malignant  in  character,  and  which  refuses  to  heal  in  a  normal 
manner,  should  not  be  neglected.  Don't  try  advertised  can- 
cer cures.  Consult  your  physician  and  be  guided  by  his 
advice. 

Cancer  is  not  contagious.     But  ordinary  care  and  cleanli- 


THE  CANCER  PROBLEM  97 

ness  should  be  observed  in  the  care  of  cancer  patients  and  all 
dressing  cloths  burned  immediately  after  removal. 

In  most  cases  taken  in  the  early  stages  the  operation  of 
removal  is  of  a  minor  character  and  attended  by  no  danger. 

Every  "  cancer  cure  "  advertisement  is  a  swindle,  and  the 
use  of  valueless  medicines  and  preparations  means  waste  of 
money  and  time.  Testimonials  of  advertising  "  specialties  " 
and  "  institutes  "  are  either  fabrications  or  are  based,  in  all 
probability,  on  the  removal  of  conditions  which  were  not 
cancer  at  all. 

WHAT  WOMEN  SHOULD  KNOW  ABOUT  CANCER 

Between  the  ages  of  35  and  45  three  times  as  many 
American  women  as  men  die  of  cancer,  between  the  ages  of 
45  and  55  twice  as  many.  Generally  speaking,  the  excessive 
mortality  among  women  is  due  to  cancer  of  the  breast  and  of 
the  generative  organs.  These  forms  of  the  disease,  like 
others,  are  curable  by  competent  treatment  in  the  early 
stages.  But  the  warning  signs  must  be  learned  and  heeded. 

\Yomen  are  more  subject  to  cancer  than  men  owing  to  the 
fact  the  special  organs  of  women  are  especially  susceptible  to 
this  disease.  One-eighth  of  all  female  deaths  above  the  age 
of  40  are  due  to  cancer,  while  only  one  death  in  every  14  of 
men  of  the  same  age  is  due  to  this  cause.  If  we  exclude 
deaths  from  cancer  of  the  breast  and  uterus  the  relative  fre- 
quency of  all  other  forms  is  about  the  same  in  the  two  sexes. 
The  civilized,  and  particularly  the  white  races,  are  more 
liable  to  cancer  in  general  than  native  races  like  the  North 
American  Indians  or  the  Orientals,  but  cancer  of  the  uterus 
seems  to  be  more  common  among  Negro  women  in  the 
United  States  than  among  the  white  women.  Cancer  of  the 
breast  and  ovaries  is  more  frequent  among  the  unmarried, 
while  by  contrast  cancer  of  the  uterus  is  more  common 
among  married  women. 


98  RACE  DECADENCE 

WHAT  EVERYONE  SHOULD  KNOW  ABOUT  CANCER 

The  following  essential  facts  about  cancer  should  be  fa- 
miliar to  every  intelligent  adult : 

1.  Cancer  begins  as  a  small  local  growth  which  often  can 
be  safely  and  easily  removed  in  the  early  stages  by  compe- 
tent surgical  treatment ;  or,  in  certain  favorable  and  superfi- 
cial cases,  by  radium  or  X-ray. 

2.  The  beginning  of  cancer  is  usually  painless ;  for  this 
reason  its  onset  is  doubly  insidious  and  other  danger  signals 
must  be  looked  for  and  heeded  in  time. 

3.  Cancer  is  not  a  constitutional  or  blood  disease  and  there 
should  be  no  thought  of  disgrace  or  direct  hereditary  taint 
associated  with  it. 

4.  Cancer  is  not  a  contagious  or  communicable  disease 
and  there  is  no  danger  from  living  in  the  same  house  or  from 
personal  contact  with  a  cancer  patient. 

5.  In  any  ordinary  sense,  cancer  is  not  inherited.     Some 
authorities  believe  that  there  may  be  inheritance  of  a  certain 
tendency  to  the  disease,  but  even  that  is  not  clearly  estab- 
lished.    The  disease  is  so  frequent  that  by  the  very  law  of 
chance  many  cases  will  occur  in  some  families.     Life  insur- 
ance companies  do  not  regard  cancer  in  the  family  as  a  reason 
for  rejecting  applicants  or  increasing  premiums. 

6.  A  persistent  lump  in  the  breast,  or  continued  abnormal 
discharge  or  bleeding  should  take  a  woman  to  her  doctor 
forthwith.     The  increased  flowing  which  frequently  occurs 
at  change  of  life,  is  always  suspicious,  as  is  the  return  of 
flowing  after  it  has  stopped.     Any  form  of  intermenstrual 
hemorrhage  should  be  regarded  with  suspicion. 

7.  Sores,  cracks,  lacerations,  lumps,  and  ulcers  which  do 
not  heal,  and  warts,  moles,  or  birthmarks  which  change  in 
color  or  appearance  are  danger  signals  which  demand  compe- 
tent medical  investigation  and  proper  treatment. 


THE  CANCER  PROBLEM  99 

8.  Persistent  indigestion  in  middle  life  with  loss  of  weight 
and  change  of  color,  may  mean  internal  cancer.     Don't  wait 
until  blood  or  "  coffee  grounds  "  are  vomited. 

9.  Continued  irritation  in  some  form  rather  than  a  sudden 
blow,  is  the  usual  cause  of  cancer. 

10.  A  doctor  who  says  "  Wait  and  see,"  assumes  a  serious 
responsibility.     No  competent  doctor  will  treat  a  suspicious 
symptom  without  making  a  thorough  examination. 

u.  Because  "  cancer  pastes  "  or  other  remedies  are  reputed 
to  have  cured  certain  superficial  cancers  of  the  skin  —  those 
with  real  and  deep-seated  cancer  are  led  to  trust  these 
"cures"  —  and  they  always  fail  in  the  presence  of  real 
cancer. 

12.  Don't  make  a  mistake  in  treating  sores  about  the  lips, 
mouth,  or  tongue.     Picking  and  irritating  such  sores,  cracks, 
ulcerations,  etc.,  or  treating  these  skin  conditions  by  home 
remedies,  pastes,  poultices,  caustics,  etc.,  is  playing  with  fire. 
Warty  growths,  moles  or  other  birthmarks,  especially  those 
subject  to  constant  irritation,  should  be  attended  to  immedi- 
ately.    Avoidance  of  chronic  irritation  and  removal  of  just 
such    seemingly    insignificant    danger    spots    may    prevent 
cancer. 

13.  Don't  be  misled  by  the  frequent  newspaper  or  maga- 
zine announcements  that  somebody  has  discovered  a  cancer 
cure.     When  the  real  cure  is  discovered  it  will  probably  be 
disclosed  through  the  scientific  channels  which  have  been 
concerned  in   working  out   the  many  problems  connected 
with  this  baffling  malady. 

14.  Don't  depend  upon  X-rays  or  radium  as  a  cure  in  the 
early  stages  —  resort  to  immediate  operation  if  the  prospects 
are  favorable.     Radium  and  X-rays  are  valuable  means  of 
treatment  when  surgery  cannot  be  employed,  or  in  certain 
other  cases  as  an  aid  to  surgery.     In  inoperable  cases  they 
may  be  used  to  great  advantage.  , 


100  RACE  DECADENCE 

SUMMARY  OF  THE  CHAPTER 

1.  Cancer  has  baffled  medical  science  and  appears  to  be  in- 
creasing.    In  less  than  twenty  years  the  death-rate  has  risen 
from  63  to  8 1  per  100,000. 

2.  Cancer  causes  one  out  of  every  10  deaths  after  the  age 
of  40  in  this  country ;  one  out  of  every  8  in  women  over  40. 

3.  We  lose  almost  100,000  people  each  year  from  cancer  in 
all  its  many  forms. 

4.  Cancer  seems  to  have  increased  300  per  cent  in  Boston 
in  thirty  years. 

5.  Cancer  ranks  among  the  six  leading  causes  of  death. 
Ninety-five  per  cent  of  deaths  occur  in  those  over  35  years 
of  age. 

6.  In  cases  of  cancer  9  out  of  10  are  fatal ;  yet,  if  proper 
steps  were  taken  early,  one-half  of  the  cancer  deaths   (at 
least)  could  be  prevented. 

7.  Of  cancer  deaths  about  35  per  cent  are  from  cancer  of 
the  stomach  and  liver;  13  per  cent  in  the  female  generative 
organs;  8.5  per  cent  in  the  breast;  3.5,  mouth;  12  per  cent 
of  the  bowels,  etc. 

8.  Sixty  per  cent  of  the  cancers  of  the  rectum  start  out  as 
hemorrhoids  —  common  piles. 

9.  The  annual  increase  is  about  2.5  per  cent.    The  re- 
corded cancer  death-rate  has  doubled  in  the  last  forty  years. 

10.  In  Chicago,  the  cancer  death-rate  is  rapidly  catching 
up  with  the  tuberculosis  death-rate. 

11.  From  ages  35  to  55  cancer  is  two  or  three  times  more 
dangerous  to  women  than  to  men.     Women  should  take 
special  precautions. 

12.  The  vital  thing  in  cancer  is  an  early  diagnosis  and 
prompt  medical  measures  —  early  and  radical  operation. 

13.  Cancer  is  at  first  a  local  disease  —  it  is  not  constitu- 
tional.   It  is  not  contagious,  and  is  not  inherited  —  though  it 
does  appear  to  "  run  in  families." 

14.  Cancer    cures    are    frauds    and    swindles,    although 
"  pastes  "  may  cure  supposed  superficial  cancer  of  the  skin. 
Radium  and  X-ray  are  valuable  —  and  they  sometimes  cure. 

15.  Everybody  should  understand  that  cancer  begins  as  a 
small   local  growth  —  usually  painless  —  and  tends  to   in- 


THE  CANCER  PROBLEM  IOI 

crease.    Later  it  ulcerates,  bleeds,  etc.,  but  should  have  atten- 
tion long  before  this  stage. 

1 6.  Lumps  in  the  breast,  or  chronic  "  piles  "  suggest  cancer 
of  the  breast  or  of  the  rectum. 

17.  Indigestion,  stomach  trouble,  and  loss  of  weight  in 
middle  life  is  suggestive  of  cancer  of  the  stomach  or  other 
internal  organs. 

1 8.  Look  out  for  moles,  birthmarks,  or  scars  which  change 
color,  get  angry,  or  bleed. 

19.  Don't  be  deceived  by  the  newspaper  announcements  of 
the  discovery  of  cancer  cures ;  and  don't  depend  too  much  on 
X-ray  or  radium.    Seek  an  early  operation. 

20.  In  the  case  of  a  woman  —  regard  with  suspicion  any 
hemorrhagic  discharge  which  may  appear  between  the  regular 
menstrual  periods.     Seek  early  surgical  advice. 


CHAPTER  VII 
THE  WHITE  PLAGUE 

WHILE  we  know  the  microbic  cause  of  tuberculosis 
and  also  are  in  possession  of  the  technique  of  cure  — 
still  the  death-rate  of  the  Great  White  Plague  only  slowly 
decreases.  Much  work  remains  to  be  done  before  this  mal- 
ady is  finally  and  completely  vanquished.  But,  since  the 
public  is  more  or  less  conversant  with  the  battle  which  is 
being  waged  against  this  disorder,  we  deem  it  advisable  to 
deal  only  with  tuberculosis  in  that  brief  manner  which  will 
serve  to  call  attention  to  the  part  it  plays  in  the  country's 
death-rate  and  to  emphasize  the  need  of  further  efforts 
being  directed  towards  its  ultimate  conquest. 

WHAT   IS  TUBERCULOSIS? 

Tuberculosis  is  a  disease  caused  by  a  microbe  —  the  tu- 
bercle bacilli  —  and,  under  favorable  conditions,  may  attack 
most  any  part  of  the  human  body ;  although  it  is  most  com- 
monly associated  with  the  lungs.  In  general  the  disease  and 
its  manifestations  are  too  well  known  to  require  extended  de- 
scription. 

Contrary  to  a  stubborn  popular  belief,  not  yet  entirely 
overcome,  tuberculosis  is  not  an  inherited  disease.  The 
daily  expectoration  of  a  consumptive  may  contain  millions 
of  germs,  and  the  belief  that  the  disease  was  inherited  was 
due  to  the  fact  that  tuberculous  fathers  and  mothers  infected 
their  children. 

Tuberculosis  is  a  secret,  insidious,  invisible  foe  that  creeps 

102 


THE  WHITE  PLAGUE  103 

upon  its  victims.     It  works  silently,  tightening  its  grip  each 
day  until  they  weaken  and  waste  away. 

The  war  of  tuberculosis  on  mankind  is  more  deadly  than 
the  wars  of  conflicting  nations.  Tuberculosis  has  caused  far 
more  widowhood  and  orphanhood  than  all  the  wars  in  which 
the  United  States  has  engaged,  the  great  Civil  War  included. 

THE    HIDDEN    ENEMY 

Predisposing  causes  of  tuberculosis  in  the  environment  are 
bad  living  and  working  conditions,  especially  impure  air, 
darkness,  dirt,  and  dust. 

Predisposing  causes  of  tuberculosis  in  the  person  are  weak- 
ened physical  condition,  overwork,  lack  of  proper  food,  alco- 
holism, dissipation,  influenza,  colds,  pneumonia,  measles, 
typhoid,  pleurisy  —  in  fact,  any  disease  that  materially 
weakens  the  system. 

Men  who  work  where  there  is  considerable  dust  are  pe- 
culiarly susceptible  to  tuberculosis.  The  metallic  dust  of 
printing  offices  and  brass  works,  the  mineral  dust  of  quarries 
and  potteries,  the  vegetable  fiber  dust  of  textile  factories  and 
paper  mills,  and  the  animal  and  mixed  fiber  dust  of  silk  and 
carpet  factories,  all  are  dangerous  because  the  dust  injures 
the  lungs  and  opens  the  way  for  the  germ  to  find  lodgement. 

The  commonest  early  symptoms  of  tuberculosis  are  a  per- 
sistent cough  or  cold,  continued  hoarseness,  loss  of  weight 
and  appetite,  a  run-down,  tired  feeling,  persistent  pain  in  the 
chest,  afternoon  temperature,  night  sweats,  spitting  of  blood, 
etc. 

THE  DEATH  TOLL 

The  deaths  from  tuberculosis  in  the  United  States  now  av- 
erage 150,000  a  year.  Every  three  minutes  some  man, 
woman,  or  child  dies  from  its  ravages  —  20  every  hour,  480 
every  day.  One-tenth  of  all  the  people  who  die  in  the  United 


104  RACE  DECADENCE 

States  are  victims  of  tuberculosis.  Yet  tuberculosis  is  a  pre- 
ventable and  curable  disease. 

The  most  formidable  obstacle  in  the  campaign  against  tu- 
berculosis is  the  undiscovered  case,  the  person  who  has 
tuberculosis  and  doesn't  know  it.  When  the  United  States 
entered  the  World  War  the  draft  boards  and  the  army  doctors 
found  more  than  100,000  such  cases  among  the  young  men 
who  thought  themselves  physically  fit  for  military  service. 

Of  the  100,000,000  now  living  in  this  country,  it  is  esti- 
mated that  8,000,000  to  10,000,000  are  doomed  to  die  of  tu- 
berculosis, unless  the  disease  is  further  checked.  The  loss  of 
life  and  treasure  is  appalling.  It  is,  therefore,  most  encour- 
aging that  preventive  measures  based  upon  modern  concep- 
tions of  the  disease  as  a  communicable  infection  are  giving 
encouraging  results. 

There  are  at  least  1,000,000  active  cases  of  tuberculosis  in 
the  United  States.  No  close  estimate  of  the  number  of  inac- 
tive cases  can  be  made.  The  health  demonstration  at  Fram- 
ingham,  Massachusetts,  where  a  whole  city  put  itself  in  the 
care  of  physicians  in  order  to  promote  health  and  further  sci- 
entific investigation,  has  revealed  that  there  are  15  cases  of 
tuberculosis  for  every  death.  This  would  indicate  a  total 
number  of  over  2,000.000  cases  in  the  whole  country,  1,000,- 
ooo  of  which  are  probably  inactive. 

Most  of  the  victims  are  taken  in  the  prime  of  life.  One- 
third  of  all  who  die  between  the  ages  of  18  and  45  are  killed 
by  tuberculosis.  The  economic  loss  to  the  nation  amounts 
to  almost  $1,000,000,000  each  year. 

Among  the  150,000  persons  who  are  killed  by  tuberculosis 
in  the  United  States  every  year  are  more  than  12,000  chil- 
dren, under  5  years  of  age.  Children  are  particularly  sus- 
ceptible to  infection.  More  than  50  per  cent  of  all  children 
are  infected  before  they  are  10  years  of  age,  and  the  per- 
centage increases  until  at  15  years  it  reaches  its  maximum  of 


THE  WHITE  PLAGUE  105 

from  60  to  70  per  cent,  and  by  21  practically  everyone  is 
more  or  less  infected. 

There  are  over  50,000  cases  of  tuberculosis  in  Illinois; 
over  25,000  in  Qiicago.  In  one  block  in  New  York  there 
were  265  deaths  in  nine  years.  We  lose  one  person  every 
hour  in  Illinois  alone  from  tuberculosis. 

One-seventh  of  all  deaths  are  caused  by  tuberculosis.  One- 
fourth  of  all  adult  deaths  are  caused  by  tuberculosis ;  while 
at  the  same  time  one-fourth  of  all  others  show  tuberculosis 
lesion,  therefore  —  one-half  of  all  adults  have  probably  had 
tuberculosis  in  some  form,  sometime  during  their  lives. 

BOVINE  TUBERCULOSIS 

Notwithstanding  all  the  discussion  pro  and  con,  it  is  un- 
doul^tedly  true  that  man  can  and  does  contract  tuberculosis 
from  cattle.  If  only  i  per  cent  of  the  deaths  from  tubercu- 
losis in  the  United  States  were  caused  by  bovine  tubercle 
bacilli,  it  would  mean  over  1,600  deaths  yearly.  It  is  now 
estimated  that  perhaps  7  per  cent  of  the  tuberculosis  in  man 
is  of  bovine  or  animal  origin. 

Woodward  voices  the  prevailing  opinion  when  he  main- 
tains that  the  more  deeply  we  go  into  the  subject,  the  bovine 
side  of  the  question  comes  to  take  a  larger  and  larger  place, 
especially  in  connection  with  surgical  and  abdominal  tubercu- 
losis, not  only  in  the  child  but  even  in  the  adult. 

From  the  standpoint  of  our  present  knowledge  we  must 
consider  that  practically  every  case  of  bovine  tuberculosis 
in  man  is  ingestion  tuberculosis,  contracted  from  milk,  or 
fresh  milk  products.  How  the  tubercle  bacilli  get  into  milk 
and  frequency  with  which  it  is  infected  are  disputed  points. 

HOW  TO  WIN  THE  BATTLE 

The  anti-tuberculosis  societies  —  for  whose  benefit  we  buy 
the  Christmas  seals  —  have  done  much  to  crystallize  the  fight 


106  RACE  DECADENCE 

on  the  Great  White  Plague  and  to  organize,  stimulate,  and 
enlighten  public  opinion,  and  have  sent  broadcast  to  the  in- 
dividual sufferer  and  the  endangered  members  of  the  family 
much  valuable  instruction  about  using  the  "  ounce  of  preven- 
tion "  which  is  so  much  better  than  the  best  "  cure  "  for  any 
disease.  The  following  practical  suggestions  are  to  be  found 
among  those  furnished  for  the  purpose  of  pointing  out  to 
the  public  how  to  prevent  the  spread  of  the  tubercular  plague. 

1.  By  teaching  the  consumptive  to  destroy  his  sputum,  so 
as  not  to  infect  his  family  or  neighbors.     Spitting  spreads 
disease,  particularly  tuberculosis. 

2.  By  teaching  all  people  not  to  sleep,  live,  or  work  in  dark 
or  badly  ventilated  rooms.     Sleeping  porches  are  great  pro- 
moters and  preservers  of  health,  but  if  they  are  beyond  one's 
means  one  should  at  least  keep  the  window  wide  open  at 
night.     (See  Fig.  7.) 

3.  By  discovering  the  disease  in  its  early  stages  and  curing 
the  patient,  thus  removing  a  source  of  infection  to  others. 
This  is  particularly  the  work  of  the  organizations  and  indi- 
vidual physicians. 

4.  By  educating  the  community  as  to  the  nature  of  the  dis- 
ease, that  it  is  communicable,  preventable,  and  curable. 

5.  By  educating  people  to  keep  their  bodies  in  such  physical 
condition  as  to  enable  them  to  resist  the  germs  of  tubercu- 
losis. 

6.  By  advocating  fresh  air,  outside  life,  sunshine,  rest,  no 
overstrain,  whether  at  work  or  in  exercise,  wholesome  food, 
and  temperate  habits. 

7.  By  safeguarding  the  health  of  children,  giving  them 
clean  places  to  play  in,  and  taking  special  care  to  keep  young 
people  away  from  sources  of  infection. 

8.  By  providing  institutions,  nurses,  and  dispensaries   for 
the  care,  cure,  and  restoration  to  a  safe  and  sane  life  of 
those  who  are  afflicted  with  the  disease. 


THE  WHITE  PLAGUE  107 

9.  By   insisting   on   periodic   physical    examinations    for 
everyone,  well  or  sick.    These  examinations  should  be  taken 
at  least  once  a  year ;  every  six  months  would  be  better,  and 
every  three  months  better  still. 

10.  Fifteen  years  ago  the  death-rate  from  tuberculosis  in 
the  United  States  was  200.7  m  eacn  100,000  of  population. 
That  meant  a  death  loss  of  200,000  a  year.    It  has  now  come 
down  to  150,000  a  year  —  hard  work  may  soon  bring  it  down 
to  100,000  a  year. 

HEREDITY  AND  TUBERCULOSIS 

When  we  say  that  tuberculosis  is  not  hereditary,  we 
mean  that  it  is  not  directly  inheritable  as  a  disease.  The 
tendency  —  the  susceptibility  —  to  tuberculosis  certainly 
"  runs  in  families ; "  it  is  even  more  prevalent  in  certain 
races.  It  is  a  well-known  fact  that  the  Irish  race  is  much 
more  susceptible  to  tuberculosis  than  is,  for  instance,  the 
Jewish  race. 

The  decline  in  the  death-rate,  from  tuberculosis,  in  the 
United  States,  is  thought  by  some  statisticians  to  be  due  to  the 
fact  that  the  American  stock  which  was  more  vulnerable  to 
tuberculosis  is  being  wiped  out,  and  that  the  remaining  popu- 
lation is  more  resistant  to  the  Great  White  Plague.  And  the 
eugenic  investigations  of  the  last  decade  go  a  long  way  toward 
sustaining  this  theory  of  family  and  racial  predisposition  to 
tubercular  infections. 

If  it  is  a  fact  that  certain  individuals  —  even  races  —  are 
born  with  a  predetermination  toward  tuberculosis,  then  we 
must  look  to  the  cause  of  eugenics  and  the  science  of  heredity 
for  further  help  along  the  lines  of  preventing  and  combating 
this  ravaging  malady.  While  we  should  not  slacken  our  ef- 
forts along  the  lines  of  hygienic  warfare  against  consump- 
tion and  other  forms  of  tuberculosis,  nevertheless  the  author 
believes  that  much  additional  assistance  might  be  gained  by  a 


108  RACE  DECADENCE 

sober  consideration  of  the  facts  and  theories  which  have  been 
developed  by  the  biologists  and  other  investigators  in  the  field 
of  genetics  and  eugenics. 

We  come  more  and  more  to  recognize  that  the  cause  of 
"  race  betterment "  is  not  to  be  advanced  entirely  by  the 
sciences  of  medicine  and  sanitation.  We  cannot  further  over- 
look the  fact  that  much  of  our  race  decadence  is  directly  due 
to  defective  germ-plasm  and  that  a  more  complete  under- 
standing and  more  effective  application  of  the  laws  of  inher- 
itance will  contribute  much  more  to  the  successful  treatment 
and  prevention  of  a  great  deaf  of  our  race  decadence  and 
degeneracy. 

SUMMARY  OF  THE  CHAPTER 

1.  Tuberculosis  is  a  microbic  disease  which  may,  under 
favorable  conditions,  attack  most  any  part  of  the  body,  al- 
though it  is  commonly  found  in  the  lungs. 

2.  Tuberculosis  is  a  secret  and  insidious  foe  causing  more 
deaths  than  all  the  wars  of  mankind ;  but  it  is  not  inherited. 

3.  The  predisposing  causes  are  bad  air,  darkness,  dust, 
overwork,    undernourishment,   alcoholism,    dissipation,   and 
all    lung    disorders    such    as    colds,    pneumonia,    influenza, 
measles,  etc. 

4.  The  earliest  symptoms  of  tuberculosis  are:  persistent 
cough  or  cold,  hoarseness,  loss  of  weight,  appetite,  and  spir- 
its, fatigue,  pain  in  the  chest,  afternoon  fever,  and  night 
sweats. 

5.  The  tuberculosis  death-rate  in  this  country  is  150,000  a 
year  —  one  every  three  minutes,  20  an  hour,  480  a  day.    It 
represents  one-tenth  of  all  our  deaths. 

6.  In  the  recent  military  draft  the  examining  surgeons 
found  more  than  100,000  unknown  cases  among  our  young 
men. 

7.  Of  the  American  people  living  today  10,000,000  are 
doomed  to  die  of  this  plague  if  it  is  not  checked. 

8.  There  are  not  less  than  1,000,000  active  cases  in  this 
country  all  the  time.    One-third  of  all  who  die  between  18 
and  45  years  perish  from  this  disease. 


THE  WHITE  PLAGUE  109 

9.  More  than  50  per  cent  of  all  children  are  infected  be- 
fore they  are  10  years  old ;  at  15  years  about  70  per  cent;  at 
21  years  practically  everyone  is  more  or  less  infected. 

10.  There  are  at  least  50,000  cases  in  Illinois ;  25,000  cases 
in  Giicago.    One  person  dies  every  hour  in  Illinois  from  tu- 
berculosis. 

11.  One-fourth  of  all  adult  deaths  are  caused  by  tuberculo- 
sis.    One-fourth  of  all  the  others  show  traces  of  the  dis- 
ease ;  therefore,  one-half  of  all  adults  probably  have  had  the 
disease  in  some  form. 

12.  Man  can  and  probably  does  contract  tuberculosis  from 
cattle.    Some  think  that  7  per  cent  of  this  disease  in  man  is 
of  animal  origin  —  received  largely  through  milk. 

13.  The  anti-tuberculosis  societies  have  performed  an  in- 
valuable service  in  public  enlightenment  and  individual  in- 
struction of  the  victims  of  this  dread  disease. 

14.  The  instructions  furnished  for  both  preventing  and 
curingtthe  disorder  are  precise  and  concise,  and  never  fail  to 
produce  results  when  faithfully  and  efficiently  applied. 

15.  Hereditary   predisposition   is   a   large    factor   in   the 
causation  of  tuberculosis  in  both  the  individual  and  in  cer- 
tain races.    Tuberculosis  does  "  run  in  families.  " 


CHAPTER  VIII 
THE  GREAT  BLACK  PLAGUE 

WE  HAVE  just  been  considering  tuberculosis.  We 
consecrate  a  Sunday  each  year  in  the  churches,  to  the 
Great  White  Plague ;  and  as  a  result  of  this  agitation,  though 
we  have  not  yet  begun  to  realize  our  full  dividends,  neverthe- 
less we  are  seeing  an  actual  decrease  in  the  mortality  from 
tuberculosis.  But  now  we  come  to  the  consideration  of  a 
group  of  diseases  which,  while  they  are  caused  by  microbic  or 
parasitic  organisms,  are  not  on  the  decrease.  They  are  the 
unmentionable  diseases  of  social  transgression  —  gonorrhea 
and  syphilis  —  and  they  constitute  the  Great  Black  Plague. 
These  two  diseases  have  scourged  society  for  centuries  in 
the  presence  of  a  conspiracy  of  silence  on  the  part  of  the 
public,  the  church,  and  the  medical  profession. 

STORY  OF  SYPHILIS 

Syphilis  was  undoubtedly  discovered  by  Columbus  along 
with  America.  His  sailors  carried  it  back  to  Europe  and  in 
a  short  while  it  spread  itself  over  the  entire  civilized  world. 
It  represents,  along  with  tobacco  and  Indian  corn,  America's 
contribution  to  latter-day  civilization. 

Syphilis  is  a  good  illustration  of  the  fact  that  it  is  much 
more  difficult  to  control  a  disease  transmitted  directly  from 
one  human  being  to  another  than  it  is  a  disease  transmitted  by 
an  intermediate  host,  or  one  in  which  the  infective  principle 
is  transferred  through  our  environment,  as  is  the  case  in  ma- 
laria. We  have  a  certain  amount  of  control  over  our  sur- 
roundings, and  we  have  dominion  over  the  lower  animals,  but 

no 


THE  GREAT  BLACK  PLAGUE         III 

the  control  of  men  and  women  requires  the  consent  of  the 
governed. 

One  attack  of  syphilis  is  supposed  to  confer  immunity,  in 
that  reinfections  do  not  produce  another  chancre.  That  is, 
the  virus  cannot  be  inoculated  upon  a  person  who  has  or 
has  had  the  disease,  but  reinfection  can  occur  as  a  result  of 
subsequent  exposure. 

Syphilis  is  usually  contracted  as  a  result  of  illicit  sex  rela- 
tions, but  may  also  be  picked  up  from  any  infected  article 
such  as  drinking  cups,  eating  utensils,  and  by  kissing,  etc. 
Children  may  be  born  with  syphilis  —  having  contracted  it 
congenitally.  The  best  authorities  are  now  about  agreed  that 
syphilis  is  not  hereditary  in  the  sense  that  insanity  is  said 
to  be  hereditary.  The  mother  is  supposed  to  have  the  dis- 
ease in  its  contagious  stage  while  carrying  her  offspring  and 
in  this  way  the  child  contracts  the  disease  and  is  born  with 
it.  ^It  is  the  case  of  a  prenatal  contagion;  not  one  of  bona 
fide  heredity. 

COURSE    OF    SYPHILIS 

Syphilis  is  caused  by  a  minute  animal  organism  called  spiro- 
chaeta  pallida  (see  Fig.  8),  and  while  this  whole  volume 
might  be  rilled  with  even  a  brief  resume  of  the  multitude  of 
symptoms  and  manifestations  of  syphilis,  the  following  sum- 
mary by  Stokes  is  right  to  the  point: 

Summing  up  briefly  the  main  points  to  bear  in  mind  about  the 
course  of  syphilis  —  there  is  a  time,  at  the  very  beginning  of  the 
disease,  even  after  the  first  sore  appears,  when  the  condition  is 
still  at  or  near  the  place  where  it  entered  the  body.  At  this  time 
it  can  be  permanently  cured  by  quick  recognition  and  thorough  treat- 
ment. There  are  no  fixed  characteristics  of  the  early  stages  of  the 
disease,  and  it  often  escapes  attention  entirely  or  is  regarded  as  a 
trifle.  The  symptoms  that  follow  the  spread  of  the  disease  over  the 
body  may  be  severe  or  mild,  but  they  seldom  endanger  life,  and 
again  often  escape  notice,  leaving  the  victim  for  some  years  a  danger 
to  other  people  from  relapses  about  which  he  may  know  nothing 


THE  SPIROCHAETA  PALLIDA-The  Cause  of  Syphilis 


THE  GONOCOCCUS  MICROBE  -The  Cause  of  Gonorrhea 


Fig.  8.    Organisms  causing  the  Great  Black  Plague 


THE  GREAT  BLACK  PLAGUE  113 

whatever.  Serious  syphilis  is  the  late  syphilis  which  overtakes  those 
whose  earlier  symptoms  passed  unrecognized  or  were  insufficiently 
treated.  Late  syphilis  of  the  skin  and  bones,  disfiguring  and  horrible 
to  look  at,  is  less  dangerous  than  the  hidden  syphilis  of  the  blood 
vessels,  the  nerves,  and  the  internal  organs,  which,  under  cover  of 
a  whole  skin  and  apparent  health,  maims  and  destroys  its  victims. 
Locomotor  ataxia  and  softening  of  the  brain,  early  apoplexy,  blind- 
ness and  deafness,  paralysis,  chronic  fatal  kidney  and  liver  disease, 
heart  failure,  hardening  of  the  blood  vessels  early  in  life,  with  sud- 
den or  lingering  death  from  any  of  these  causes  are  among  the  ways 
in  which  syphilis  destroys  innocent  and  guilty  alike.  And  yet,  for 
all  its  destructive  power,  it  is  one  of  the  easiest  diseases  to  hold  in 
check,  and  if  intelligently  treated  at  almost  any  but  the  last  stages, 
can,  in  the  great  majority  of  cases,  be  kept  from  endangering  life. 

BLOOD  TEST    FOR   SYPHILIS 

(Wassermann  Test) 

Certain  practical  details  about  this  test  are  of  interest  to 
everyone.  Blood  for  it  is  usually  drawn  from  a  small  vein 
in  tHe  arm.  The  discomfort  is  insignificant  —  no  more  than 
that  of  a  sharp  pin-prick.  Blood  is  drawn  in  the  same  way 
for  other  kinds  of  blood  tests,  so  that  a  needle-prick  in  the 
arm  is  not  necessarily  for  a  Wassermann  test.  There  is  no 
cutting,  and  no  scar  remains.  The  amount  of  blood  drawn 
is  so  small  that  it  does  not  weaken  in  the  least.  The  test  is 
done  on  the  serum  or  fluid  part  of  the  blood,  after  the  cor- 
puscles are  removed.  It  can  also  be  done  on  the  clear  fluid 
taken  from  around  the  spinal  cord,  and  this  is  necessary  in 
certain  syphilitic  nervous  diseases.  There  is  nothing  about 
the  test  that  need  make  anybody  hesitate  in  taking  it,  and  it  is 
safe  to  say  that  when  properly  done,  the  information  that  it 
gives  is  more  than  worth  the  trouble,  especially  to  those  who 
have  at  any  time  been  exposed,  even  remotely,  to  the  risk 
of  infection.  But  the  test  must  be  well  done  in  a  large  hospi- 
tal or  through  a  competent  physician  or  specialist,  and  the 
result  interpreted  to  the  patient  by  the  physician  and  not  by 
the  laboratory  that  does  the  test,  or  in  the  light  of  the  pa- 


H4  RACE  DECADENCE 

tient's  own  half -knowledge  of  the  matter.  While  the  Was- 
sermann  test  is  not  infallible,  the  author  regards  it  as  the 
most  reliable  single  evidence  of  syphilis  —  not  overlooking, 
of  course,  the  actual  manifestations  of  the  disease  —  and  we 
regard  it  as  an  authentic  indication  of  the  presence  of  the 
disease  nine  times  out  of  ten,  when  the  test  shows  positive  in 
the  hands  of  a  competent  technician. 

TREATMENT    OF    SYPHILIS 

Whenever  one  talks  to  a  person  who  knows  something 
of  the  advances  in  knowledge  in  the  past  few  years  about  the 
treatment  of  syphilis,  and  goes  into  detail  about  mercury,  the 
odds  are  two  to  one  that  he  will  be  interrupted  by  the  ques- 
tion, "  But  what  about '  606  '  ?  "  Before  talking  about  salvar- 
san,  or  "  606,"  it  is  well  to  say  here  that  this  new  drug,  won- 
derful though  it  is,  has  in  no  sense  done  away  with  the  use 
of  mercury  in  the  treatment  of  syphilis.  "  Mercury  has  as 
high  a  reputation  and  is  as  indispensable  in  the  cure  of  syph- 
ilis today  as  it  was  two  hundred  years  ago.  It  has  as  yet  no 
substitutes/'  We  appreciate  every  day,  more  and  more,  how 
thoroughly  it  can  be  depended  on  to  do  the  work  we  expect 
of  it.  A  drug  known  as  potassium  iodid  is  widely  used  in  the 
treatment  of  syphilis,  and  especially  of  the  late  forms  of  the 
disease,  such  as  gummas  (internal  tumors)  and  gummatous 
sores.  It  has  a  peculiar  effect  on  gummatous  tissue,  causing 
it  to  melt  away,  so  to  speak,  and  greatly  hastening  the  heal- 
ing process.  So  remarkable  is  this  effect  that  it  gives  the  im- 
pression that  iodids  are  really  curing  the  syphilis  itself.  "  It 
has  been  shown,  however,  that  iodids  have  no  effect  upon  the 
germs  of  syphilis,  and  therefore  on  the  cause  of  the  disease, 
although  they  can  promote  the  healing  of  the  sores  in  the 
late  stages."  For  this  reason  mercury  must  always  be  used 
in  connection  with  iodids  if  the  disease  itself  is  to  be  cured. 
It  is  occasionally  difficult  to  get  patients  to  understand  this 


THE  GREA  T  BLA  CK  PL  A  CUE  1 1 5 

after  they  have  once  taken  "  drops  "  as  the  medicine  (iodids) 
is  often  called. 

Most  insurance  companies  refuse  to  accept  untreated 
syphilitics  at  all.  Some  companies  require  extra  premiums 
to  compensate  for  the  extra  risks;  a  few  companies  will 
accept  exceptionally  favorable  cases  who  have  had  a  thor- 
ough course  of  treatment,  and  who  have  shown  no  symptoms 
for  three  to  five  years,  but  under  these  circumstances  only 
special  policies  are  contracted  for  which  do  not  keep  the  appli- 
cant on  the  companies'  books  after  55  years  of  age. 

To  effect  a  practical  cure  of  syphilis  —  that  is,  such  a  cure 
as  will  enable  the  patient  to  get  married  with  reasonable 
assurance  that  he  will  not  infect  his  wife  and  that  his  children 
will  not  be  infected  when  they  are  born,  and  also  to  be  rea- 
sonably certain  that  he  will  not  be  affected  with  locomotor 
ataxia  and  other  late  manifestations  —  in  order  to  bring  about 
such  a  probable  cure  —  it  is  desirable  that  the  patient  should 
begin  his  treatment  at  the  earliest  possible  moment  and  con- 
tinue it  uninterruptedly  for  from  one  to  two  years.  Then,  if 
the  Wassermann  tests  are  repeatedly  negative  and  otherwise 
everything  is  satisfactory  to  the  attending  physician  the 
patient  may  continue  under  observation  for  two  or  three  years 
more  —  being  subjected  to  repeated  blood  tests  and  submit- 
ting from  time  to  time  to  any  further  treatment  indicated  by 
the  results  of  these  repeated  Wassermann  tests.  We  like  to 
have  patients  give  continuous  negative  Wassermann  tests  for 
at  least  two  years  before  they  get  married.  As  a  rule  we  do 
not  permit  a  patient  to  marry  much  under  five  years  from  the 
beginning  of  the  infection  or  treatment ;  although  the  thor- 
ough and  early  treatment  of  the  infection  will  often  make  it 
reasonably  safe  to  shorten  up  this  waiting  period  somewhat. 

Both  the  patient  and  the  physician  should  play  safe.  Take 
no  chances.  The  consequences  of  infecting  an  innocent  wife 
and  thus  to  result  in  either  a  syphilitic  miscarriage  or  in 


Il6  RACE  DECADENCE 

bringing  into  the  world  a  deformed  or  defective  child  are 
altogether  too  terrible  and  serious  to  warrant  any  degree  of 
trifling  or  careless  guesswork. 

GONORRHEA 

Gonorrhea  is  an  infection  of  any  mucus  membrane  (usually 
the  sexual  tract)  by  the  microbe  known  as  the  "  gono- 
coccus  "  germ.  ( See  Fig.  8. )  It  is  nearly  always  contracted 
during  sex  relations.  The  gonococcus  sometimes  invades  the 
blood  and  produces  a  general  septicemia,  or  blood  poisoning, 
and  death  may  occur  from  endocarditis  —  heart  disease. 
Gonorrheal  arthritis  (rheumatism)  is,  in  many  respects,  the 
most  damaging,  disabling,  and  serious  of  all  the  complications 
of  this  dreadful  disease.  It  may  even  follow  ophthalmia  neo- 
natorum  —  gonorrheal  inflammation  of  the  eyes  of  a  new- 
born babe. 

Sterility  is  one  of  the  serious  consequences  of  gonorrhea. 
This  may  be  caused  in  the  male  through  epididymitis  (in- 
flammation of  the  duct  of  the  testicle),  which  is  a  very  com- 
mon complication;  and  in  the  female  by  salpingitis  (inflam- 
mation of  the  Fallopian  tubes),  which  closes  or  obstructs 
the  Fallopian  tube  to  the  passage  of  the  ovum.  Stricture  of 
the  urethra  in  the  male  is  a  very  frequent  sequel  and  results, 
sometimes,  in  life-long  trouble  —  not  to  mention  its  probable 
connection  with  premature  prostatic  troubles. 

Gonorrhea,  while  usually  cured  without  apparent  loss  of 
health,  has  always  serious  possibilities;  it  kills  about  one  in 
200;  it  impairs  the  sexual  power  and  fertility  of  a  much 
larger  number;  and  as  has  been  noted  it  often  produces 
urethral  strictures,  which  later  may  cause  loss  of  life. 

The  persistence  of  gonorrhea  in  the  deeper  parts  long  after 
it  is  outwardly  cured  leads  to  the  unsuspected  communication 
of  the  disease  to  innocent  and  unsuspecting  individuals  with 
whom  the  infected  person  may  cohabit.  Much  of  the  surgery 


THE  GREAT  BLACK  PLAGUE         II? 

performed  upon  women  has  been  rendered  necessary  by 
gonorrhea  contracted  from  the  husband.  Should  she  while 
infected  with  this  disease  give  birth  to  a  child,  the  baby's 
eyes  may  be  attacked  (unless  properly  treated  by  the  physi- 
cian at  the  time  of  delivery),  sometimes  causing  blindness. 

Gonorrheal  infections  in  children  require  special  considera- 
tion. The  frequency  of  such  infection  may  be  judged  from 
the  observations  of  Pollack  who  reports  187  cases  treated  in 
the  Woman's  Venereal  Department  of  Johns  Hopkins  Hos- 
pital during  one  year.  Pollack  estimates  that  800  to  1,000 
children  are  infected  each  year  in  Baltimore,  and  that  the 
same  proportion  probably  holds  good  for  other  cities.  The 
cause  of  the  frequent  infection  among  children  is  in  part  the 
abominable  superstition  that  a  person  afflicted  with  syphilis 
or  gonorrhea  may  get  rid  of  it  by  infecting  another  —  espe- 
cially a.  virgin. 

TREATMENT  OF  GONORRHEA 

A  gonorrheal  infection  is  sometimes  very  difficult  com- 
pletely and  permanently  to  cure.  In  most  cases  it  is  certainly 
far  different  from  the  popular  impression  that  used  to  pre- 
vail among  some  of  the  laity  that  the  contraction  of  this 
disease  was  no  worse  than  catching  a  "  bad  cold."  If  the 
infection  is  taken  promptly,  and  is  treated  faithfully  and 
heroically,  it  may  pass  through  its  worst  stages  in  a  few 
weeks  or  at  most  in  a  few  months ;  or  it  may,  even  with  the 
best  of  treatment,  be  prolonged  for  a  good  many  months ;  but 
the  greatest  mischief  is  wrought  in  those  cases  where  it  is 
tardily  or  improperly  treated  and  where  it  is  allowed  to  run 
through  a  chronic  course  of  months  or  years.  And  then  in 
the  case  of  the  young,  unmarried  man,  a  crime  is  committed 
when  he  is  permitted  on  the  part  of  his  medical  advisers,  or 
presumes  on  his  own  responsibility,  to  get  married  before 
the  disease  is  finally  eradicated. 


Il8  RACE  DECADENCE 

How  many  cases  we  see  of  strong,  healthy  young  women, 
who  have  never  experienced  a  day  of  sickness,  who  marry 
some  young  man  with  just  such  a  case  of  uncured  gono- 
coccus  infection,  and  then,  in  less  than  a  year  after  the  mar- 
riage, the  young  bride  is  in  the  hospital,  dangerously  sick, 
with  high  fever,  and  ultimately  undergoes  a  surgical  opera- 
tion which,  in  many  instances,  forever  precludes  the  possi- 
bility of  her  becoming  a  mother.  She  has  been  ruthlessly 
infected  through  the  criminal  carelessness  of  her  husband 
who  married  her  having  every  reason  to  know  that  he  was 
not  fully  cured ;  she  has  been  unsexed  and  in  many  instances 
practically  ruined  for  life. 

The  modern  treatment  of  the  disease  consists  of  three 
parts :  First :  combating  the  infection  with  local  antiseptics 
under  the  direction  of  a  skilled  physician;  Second:  the  use 
of  gonococcus  vaccines,  and,  Third:  good  general  hygiene 
and  every  other  effort  tending  to  upbuild  the  patient's  health 
and  resistance.  And  the  treatment  must  be  carried  out  con- 
scientiously and  continuously  until  a  cure  is  effected.  The 
evidence  of  complete  cure  consists  in  certain  examinations  of 
the  urine,  local  examinations,  and  in  the  so-called  "  comple- 
ment fixation  test,"  which  is  a  test  for  gonorrhea  that  is 
analogous  to  the  Wassermann  test  for  syphilis,  and  while 
it  is  neither  so  valuable  nor  so  reliable,  yet  it  is  a  considerable 
aid  in  helping  to  check  up  doubtful  cases,  as  regards  perma- 
nency of  cure. 

Every  intelligent  person  should  be  warned  against  the 
dangers  of  neglecting  the  treatment  of  gonorrhea,  which, 
in  the  case  of  the  male,  may  result  in  urethral  stricture, 
gonorrheal  rheumatism,  or  more  serious  prostatic  and  glandu- 
lar trouble  and  even  in  sterility.  In  the  case  of  the  female, 
there  is  the  same  danger  of  gonorrheal  rheumatism,  but  the 
chief  jeopardy  is  that  the  infection  may  ascend  up  the  gen- 
erative passages,  and  reach  the  Fallopian  tubes  and  produce 


THE  GREAT  BLACK  PLAGUE         119 

infection  on  one  or  both  sides  that  may  result  in  either 
a  serious  surgical  operation  or  sterility,  if  not  both.  Em- 
phatic warning  should  also  be  given  against  depending  upon 
home  treatment  or  prescriptions  and  remedies  recommended 
by  druggists,  all  of  which  will  prove  more  or  less  futile  and 
lead  to  bitter  disappointment  and  in  many  instances  to  serious 
consequences.  When  you  are  infected  with  a  venereal  dis- 
ease, go  to  the  best  specialist  in  that  line  whom  you  know, 
or  take  the  matter  up  with  your  family  physician  and  get 
advice  as  to  where  you  should  go  for  treatment.  If  limited 
in  means,  proceed  at  once  to  a  dispensary  or  other  charitable 
institution  for  the  care  of  such  cases. 

OTHER  VENEREAL  DISEASES 

Soft  chancre,  in  contradistinction  to  the  chancre  which 
constitutes  the  initial  lesion  of  syphilis,  is  a  semifilth  disease 
of  microbic  origin,  associated  with  and  affecting  the  sexual 
organs.  It  is  not  always  easy  for  the  novice  to  differentiate 
between  this  local  and  apparently  harmless  chancre  and  the 
initial  lesion  of  syphilis,  but  the  experienced  physician  will 
always  be  able  to  make  such  a  diagnosis.  This  disease  is 
purely  local  and  leaves  no  known  constitutional  after-effects. 
It  has  led  many  of  its  victims  to  fear  that  they  had  syphilis, 
and  to  spend  unnecessary  worry,  time,  and  money  in  being 
treated  for  a  disease  they  never  had. 

There  has  recently  appeared  in  some  of  the  large  cities  of 
this  country  a  calamitous  sexual  disorder  known  as  "  The 
Fourth  Disease."  But  iew  cases,  thus  far,  have  been  re- 
ported, but  it  is  a  frightful  affliction  consisting  of  a  sort  of 
gangrenous  destruction  of  the  sexual  organs.  It  is  reputed 
to  be  contracted  as  the  result  of  certain  unnatural  and  repre- 
hensible sex  practices,  and  would  indeed  prove  to  be  a  veri- 
table plague  if  it  should  become  greatly  increased  in 
frequency. 


120  RACE  DECADENCE 

Much  of  the  prostatic  trouble  of  old  men  and  the  so-called 
"  female  complaints  "  of  women  owe  their  origin  to  venereal 
infections,  while  of  course  many  instances  are  due  to  perfectly 
natural  causes  —  to  age  in  the  case  of  prostatic  enlarge- 
ment —  and  are  in  no  way  connected  with  these  diseases  of 
sex  misbehavior. 

Many  cases  of  so-called  "  female  complaint  "  —  if  they  are 
not  more  or  less  imaginary  —  owe  their  existence  directly  or 
indirectly  to  the  performance  of  abortions.  One  authority, 
not  long  since,  estimated  that  one-half  of  all  pregnancies  in 
the  United  States  were  terminated  by  abortion,  while  another 
physician  estimates  that  there  are  between  50,000  and  75,000 
abortions  performed  each  year  in  Chicago. 

PROSTITUTION 

The  American  Social  Hygiene  Association  quotes  Vedder 
as  saying  that  90  per  cent  of  all  sexually  acquired  syphilitic 
infections  in  men  are  derived  from  prostitutes,  either  profes- 
sional or  amateur;  72  per  cent  of  all  prostitutes  have  at  least 
one  venereal  disease,  and  a  large  proportion  are  infective  at 
any  given  moment.  This  conclusion  is  an  average  of  four 
extensive  studies  made  in  this  country.  Another  set  of  four 
studies  showed  an  average  of  96  per  cent  infected.  For  ex- 
ample, Ball  and  Thomas  found  that  97  per  cent  of  320  prosti- 
tutes on  the  "  Barbary  Coast,"  San  Francisco,  had  syphilis, 
and  the  Detroit  Health  Department  found  that  94  per  cent 
of  224  women  in  the  Detroit  red-light  district  had  some  form 
of  venereal  infection. 

Sir  William  Osier  is  quoted  as  saying  that  85  per  cent  of 
prostitutes  in  Cologne  are  syphilitic. 

Perhaps  the  most  striking  way  of  making  clear  how  widely 
prostitutes  may  spread  venereal  diseases  is  to  call  attention  to 
the  number  of  men  which  one  immoral  woman  may  entertain 
in  one  day.  The  Chicago  Vice  Commission  quotes  the  testi- 


THE  GREAT  BLACK  PLAGUE         121 

mony  of  one  case  which  went  to  the  Supreme  Court :  "  It  is 
shown  that  six  regular  inmates,  on  four  consecutive  days,  re- 
ceived 394  men,  an  average  of  between  65  and  66  per  day, 
or  13  per  day  each."  There  is  no  need  of  multiplying  illus- 
trations. Even  the  inmates  of  the  poorly  advertised  houses 
of  prostitution  which  are  maintained  in  spite  of  the  aboli- 
tion of  the  old  red-light  districts  are  capable  of  spreading 
infection  broadcast. 

Someone  has  estimated  that  we  have  over  1,000,000  pros- 
titutes in  the  United  States;  that  this  vast  army  of  vice 
requires  60,000  recruits  annually,  5,000  a  month,  almost 
200  a  night  —  one  every  8  minutes.  This  is  probably  esti- 
mated on  the  basis  of  opinion  that  the  average  length  of  life 
for  the  public  prostitute  is  little  more  than  five  years. 

The  recent  experiences  of  the  medical  officers  of  the 
United  States  Army  have  demonstrated  that  prostitution  can 
be  controlled  and  venereal  diseases  largely  prevented. 

It  should  be  said  to  the  credit  of  the  military  authorities 
in  the  recent  World  War  that  they  did  not  permit  the  repe- 
tition of  the  disgraceful  mobilization  of  the  forces  of  vice 
which  characterized  the  assembly  of  our  soldiers  a  short 
time  before  on  the  Mexican  border,  where  syphilitic  prosti- 
tutes are  known  to  have  served  one  hundred  men  a  day. 

In  Europe  the  war  increased  syphilis  over  50  per  cent  in 
many  cities ;  while  venereal  disease  caused  more  incapacity 
for  military  service  than  all  the  fighting  at  the  front  in  the 
early  days  of  the  World  War  —  at  least  that  was  the  report 
of  one  of  the  great  powers  for  the  first  eighteen  months  of 
the  war. 

Stokes  estimates  the  number  of  persons  in  the  United 
States  who  have  had  syphilis  as  3,842,526,  and  further 
adds :  "  Since  public  and  secret  prostitution  serve  as  the 
principal  agencies  for  the  dissemination  of  the  disease,  it 
follows  that  anything  tending  to  decrease  the  amount  of 


122  RACE  DECADENCE 

disease  in  prostitutes  on  the  one  hand,  or  to  diminish  the 
amount  of  promiscuous  activity  on  the  other,  will  retard  the 
spread  of  syphilis ;  80  to  85  per  cent  of  prostitutes  at  some 
time  in  their  careers  acquire  the  disease  (syphilis)." 

Stokes,  averaging  a  number  of  large  European  cities, 
found  that  not  more  than  40  per  cent  of  prostitutes  were 
even  free  of  the  outward  signs  of  syphilis,  to  say  nothing  of 
what  laboratory  tests  might  have  revealed.  It  is  more  than 
evident  that  prostitution  is  admirably  fitted  to  play  the  lead- 
ing role  in  the  dissemination  of  this  disease. 

VENEREAL   DISEASE   STATISTICS 

Almost  4,000,000  persons  in  the  United  States  are  esti- 
mated to  have  had  syphilis  some  time  in  their  past  lives. 

Among  the  troops  in  the  Philippines  the  venereal  morbidity 
during  the  year  1904,  was  297  per  1,000,  largely  exceeding 
the  morbidity  from  malarial  fevers  and  diarrhea,  as  22  out 
of  every  1,000  soldiers  were  constantly  ineffective  from 
venereal  disease  —  four  times  as  many  as  from  any  other 
disease.  The  statistics  outside  of  army  and  navy  service  are 
not  available,  but  there  is  some  reason  to  believe  that  they 
might  show  an  even  larger  morbidity. 

The  report  of  the  Committee  of  Seven  (New  York) 
shows  that  in  private  practice  nearly  30  per  cent  of  venereally 
infected  women  were  contaminated  by  their  husbands.  The 
report  of  the  Committee  of  Sanitary  and  Moral  Prophylaxis 
(Baltimore)  shows  that  nearly  40  per  cent  of  the  infections 
in  women  seen  in  private  practice  were  communicated  in 
married  life.  Says  one  surgeon :  "  My  own  observations  at 
the  New  York  Hospital,  extending  over  a  period  of  several 
years,  would  indicate  that  fully  70  per  cent  of  all  women 
who  came  there  for  treatment  of  syphilis  were  respectable 
married  women  who  had  been  infected  by  their  husbands." 

Gynecologists    furnish   statistical   evidence   showing   that 


THE  GREAT  BLACK  PLAGUE         123 

80  per  cent  of  the  deaths  due  to  inflammatory  diseases 
peculiar  to  women  and  about  70  per  cent  of  all  the  work  done 
by  specialists  for  diseases  of  women  is  caused  by  gonorrhea. 

It  is,  of  course,  almost  impossible  to  secure  reliable  statis- 
tics on  a  large  scale  respecting  venereal  disorders.  Some 
recent  estimates  by  reliable  authorities  are  as  follows: 
Blaschko  thinks  that  of  the  clerks  of  Berlin  from  18  to  28 
years  of  age,  45  per  cent  have  syphilis.  Pinkus  estimates 
that  one  man  in  five  in  Germany  has  had  it.  Vedder  says 
that  20  per  cent  of  the  men  applying  for  army  enlistment 
in  this  country  have  had  syphilis.  He  also  states  that  5  per 
cent  of  West  Point  entrants  are  infected.  Nicols  says  from 
5  to  7  per  cent  of  the  army  have  the  disease.  Some  general 
conclusions  based  on  these  estimates  for  the  whole  country 
would  be  as  follows: 

'I.  About  one  man  in  ten  has  syphilis. 

2.  Women  have  the  disease  in  about  the  proportion  of  one 
woman  to  five  men. 

3.  This  would  give  us  in  the  United  States   (excluding 
all  under  15  years  of  age)  about  4,000,000  syphilitics. 

In  Laennec's  clinic  of  Paris  15  per  cent  of  the  women 
and  25  per  cent  of  the  men  had  syphilis. 

Erb  thinks  that  12  per  cent  of  the  males  of  both  Berlin  and 
London  are  infected. 

Fournier  estimates  15  per  cent  of  the  males  of  Paris  as 
having  syphilis. 

Collies  says  that  9.2  per  cent  of  British  workingmen  show 
syphilis  by  the  Wassermann  test. 

Of  1,000,000  patients  in  the  United  States  Public  Health 
and  War  Hospital  service  8  per  cent  had  syphilis. 

Pusey  thinks  that  5  per  cent  of  the  men  and  I  per  cent 
of  the  women  in  this  country  are  syphilitic  —  about  3  per 
cent  of  the  entire  population.  That  80  to  85  per  cent  of 
American  prostitutes  have  syphilis  at  some  time. 


124  RACE  DECADENCE 

Vedder  and  Hough  estimate  that  10  per  cent  of  the  adult 
males  in  the  United  States  have  had  syphilis. 

Statistics  based  on  180,000  cases  show  one  child  in  148, 
from  2  to  12  years  of  age,  has  so-called  hereditary  syphilis. 

It  may  surprise  some  to  know  that  while  tuberculosis 
claims  1,000,000  every  year,  considerably  more  than  that 
number  (one  authority  estimating  it  at  two  and  a  half  times 
more)  annually  contract  venereal  diseases  —  of  one  sort  or 
another. 

Dr.  Prince  A.  Morrow  declares : 

This  social  danger  comes  from  frequent  introductions  of  these 
diseases  into  marriage.  The  frequency  of  marital  contamination 
does  not  admit  of  exact  mathematical  expression,  as  both  social 
sentiment  and  professional  ethics  unite  to  cover  up  and  conceal  it. 
Possibly  10  per  cent  of  men  who  marry  infect  their  wives  with 
some  form  of  venereal  disease. 

Williams  estimates  that: 

Ten  per  cent  of  patients  in  Massachusetts  State  Hospital  for  In- 
sane have  syphilitic  insanity.  Fifteen  per  cent  in  Boston  Psycho- 
pathic Hospital  have  syphilis  in  some  form.  In  New  York  State 
Hospital  12.7  per  cent  have  syphilitic  insanity;  and  that  in  the  next 
five  years,  there  are  1,500  persons  in  Massachusetts  who  will  go 
insane  through  syphilis. 

In  the  Austrian  Army,  of  4,134  cases  of  syphilis  studied, 
4.6  per  cent  developed  paresis  (softening  of  the  brain)  • 
Vhile  i  .6  per  cent  developed  tabes  —  locomotor  ataxia. 

Gonorrhea  is  transmitted  to  wife  and  child,  causing  about 
50  per  cent  of  all  the  operations  upon  the  generative  organs 
of  women,  and  about  25  per  cent  of  all  blindness  in  the 
United  States. 

There  is  undoubtedly  a  greater  number  of  persons  infected 
with  gonorrhea  in  the  country  at  any  time  than  there  are 
syphilitics;  and  5,000,000  is  probably  a  very  conservative 
estimate  of  the  number  of  men  and  women  who  have  the 
disease  in  some  stage  or  other  at  the  present  time  —  or  who 


THE  GREAT  BLACK  PLAGUE         12$ 

have  had  it  so  recently  as  to  make  it  doubtful  if  they  are 
completely  cured. 

I  think  the  best  authorities  doubt  if  syphilis  is  on  the 
increase  in  this  country.  It  is  probably  about  stationary 
at  present. 

THE   VENEREAL    PROBLEM 

One  of  the  physicians  of  the  United  States  Public  Health 
Service  (Dr.  Stone)  recently  said: 

There  isn't  any  problem  as  great  before  us  as  the  problem  of 
venereal  disease  control,  the  question  of  handling  it,  the  question 
of  controlling  the  hidden  menace  of  society,  the  diseases  of  gonorrhea 
and  syphilis  that  are  sapping  at  the  vitals  of  practically  every  young 
man  in  America.  It  is  estimated  that  770,000  men  reach  the  age 
of  21  every  year  in  the  United  States.  Of  these  770,000  a  con- 
servative estimate  puts  over  450,000  of  them,  or  60  per  cent,  as 
contracting  gonorrhea  or  syphilis  before  they  reach  the  age  of 
30  years.  Isn't  the  problem  a  big  one?  Isn't  the  problem  a  big  one 
when  60  per  cent  of  our  young  men  contract  a  venereal  disease  be- 
fore they  reach  the  age  of  30?  Isn't  the  problem  big  enough  for 
the  medical  profession  to  wade  into  and  say  we  are  going  to  clean 
it  up?  We  have  been  facjng  for  too  many  years  these  hidden 
diseases.  They  haven't  been  brought  into  the  light  of  day.  We 
have  been  allowing  the  venereal  diseases  to  steal  out  in  the  dark 
and  stab  our  young  manhood  in  the  back  and  then  run  away  —  all 
this  because  of  that  damnable  curse  of  society  —  mock  modesty  — 
this  curse  has  taught  us  to  hide  behind  our  hands  and  blush  at  the 
mention  of  the  holiest  of  all  functions  in  nature,  the  reproductive 
function,  and  has  taught  us  to  blush  and  say :  "  Oh,  we  must  not 
talk  about  that ;  we  must  not  say  anything  at  all  about  it ;  I  tell 
my  child  ?  Oh,  no,  no,  no !  It  is  wrong  to  speak  of  it." 

When  you  figure  the  cost  of  venereal  diseases  to  society, 
you  find  that  it  is  estimated  that  the  venereal  diseases  cause 
a  total  —  direct  and  indirect  —  economic  loss  of  around 
$5,000,000,000  a  year.  If  the  average  employer  would  take 
the  trouble  to  employ  a  good  doctor  to  examine  every  one  of 
his  employees  and  to  instruct  that  doctor  that  in  the  event  an 
individual  was  found  to  be  suffering  from  a  venereal  dis- 


126  RACE  DECADENCE 

ease  he  should  not  be  discharged  but  treated  as  he  would  if 
he  had  some  other  trouble,  the  efficiency  of  their  men  would 
be  raised  from  50  to  75  per  cent. 

HOW  TO  FIGHT  THE  BLACK  PLAGUE 

The  repeated  sifting  of  the  facts  which  have  accumulated 
in  recent  years  by  important  investigations,  such  as  that  of 
the  Sydenham  Commission  in  Great  Britain  and  the  Society 
for  Combatting  Sexual  Disease  in  Germany,  and  the  legis- 
lative programs  already  under  way,  have  gradually  crystal- 
lized into  fairly  definite  form,  the  undoubted  essentials  of  a 
program  for  controlling  venereal  diseases,  syphilis  among 
them.  These  have  been  summarized  as  follows : 

1.  The  provision  of  universally  available  good  treatment, 
at  the  expense  of  the  state,  if  necessary,  for  the  disease  in 
question. 

2.  The  provision  by  the  state  of  efficient  means  of  recog- 
nizing the  diseases  at  the  earliest  possible  time  and  with  the 
greatest  possible  certainty  in  any  given  time. 

3.  The  suppression  of  quack  practice,  drug-store  prescrib- 
ing, and  advertising  of  cures  for  these  diseases. 

4.  Moral  and  educational  prophylaxis  and  the  vigorous 
suppression  of  prostitution. 

In  addition  to  these  measures,  which  are  common  to  all 
proposals  and  working  systems  for  the  control  of  sexual 
disease,  certain  other  recommendations  may  be  classed  as 
debatable,  inasmuch  as  they  are  still  under  discussion.  These 
are  as  follows : 

1.  General   instruction   in   personal  prophylaxis    for  the 
population  at  large ;  the  removal  of  the  whole  question  from 
the  realms  of  religion  and  ethics. 

2.  Compulsory  measures  and  penalties  obliging  patients 
to  receive  treatment  and  continue  it  until  cured,  regardless 
of  their  own  desires  in  the  matter. 


THE  GREAT  BLACK  PLAGUE         127 

3.  Notification  or  reporting  of  cases  of  sexual  disease  to 
the  health  authorities,  treating  these  diseases  just  as  we  do 
smallpox  or  tuberculosis. 

4.  Indirect  legislation,  as  it  might  be  called,  which  aims 
to  detect  infected  persons  before  they  enter  on  marriage 
rather  than  at  the  outset  of  the  disease,  either  by  releasing 
the  physician  in  charge  of  the  case  from  the  bond  of  pro- 
fessional confidence,  or  by  requiring  health  certificates  before 
marriage,   and   which   annuls   marriage   after   infection  is 
discovered. 

Last,  but  not  least,  let  us  emphasize  continence.  One  of 
the  important  facts  to  teach  boys  is  that  continence  is  com- 
patible with  health.  The  sex  glands  are  like  the  tear  glands 
and  the  sweat  glands,  in  that  they  do  not  atrophy  with  dis- 
use. Benjamin  Franklin  taught,  as  many  another  man  of 
influence  believes  today,  that  the  exercise  of  the  sexual 
functions  is  necessary  for  health.  This  is  a  mistake  and  has 
done  much  harm.  A  statement  declaring  that  there  is  no 
evidence  that  abstinence  is  "  inconsistent  with  the  highest 
physical,  mental,  and  moral  efficiency "  has  recently  been 
signed  by  360  of  the  foremost  medical  authorities  in  the 
United  States. 

HEREDITY  AND  MORALITY 

While  venereal  infection  is  largely  a  question  of  scientific 
treatment  and  sanitary  regulation,  the  question  of  character 
and  morality  which  are  indirectly  involved  in  any  discus- 
sion of  the  sexual  vices  must  be  looked  upon  as  falling  into 
the  domains  of  education  and  inheritance.  Early  training 
has  much  to  do  with  the  acquirement  of  the  moral  or 
righteous  viewpoint  of  sex  conduct. 

But,  independent  of  education  and  training,  heredity  has 
a  great  deal  to  do  with  the  determination  of  the  individual's 
fundamental  moral  character.  The  recent  disclosures  of 


128  RACE  DECADENCE 

numerous  eugenic  investigations  serve  unmistakably  to  show 
that  sexual  morality  is  a  trait  of  human  inheritance.  Some 
families  are  inherently  moral,  some  are  notoriously  and 
inherently  immoral.  Not  only  that,  but  sexually  speaking, 
some  races  are  more  moral  than  others. 

While  immorality  is  so  often  associated  with  various  shades 
of  feeble-mindedness,  and  various  degrees  of  biologic  degen- 
eracy, at  the  same  time  these  tendencies  toward  vice  are 
also  found  in  those  families  and  strains  which  are  not  other- 
wise degenerate  or  defective.  That  is,  the  eugenist  today 
recognizes  moral  degeneracy  or  sexual  defectiveness  as  a 
specific  form  of  race  decadence  which  is  directly  transmissible 
from  one  generation  to  the  next. 

And  so,  it  would  seem,  the  time  has  come  when  the  social 
reformer  —  the  moralist  —  must  take  into  his  counsels  the 
eugenist  with  his  discoveries  and  teachings  concerning  the 
laws  of  inheritance  as  related  to  sex  morality.  It  would 
seem  that  we  cannot  expect  any  great  degree  of  moral  prog- 
ress among  a  people  if  we  do  nothing  to  cut  off  the  unlim- 
ited reproduction  of  those  families  and  strains  which  are"* 
inherently  immoral.  And  especially  must  we  recognize  the 
menacing  threat  of  this  condition  of  affairs  if,  at  the  same 
time,  the  more  highly  moral  stocks  of  the  race  enlist  in  the 
practice  of  race  suicide. 

These  perplexing  problems  of  vice  and  immorality  are 
not  going  to  be  solved,  either  by  the  physicians,  on  the  one 
hand,  or  the  sociologists  and  reformers,  on  the  other,  until 
we  have  taken  into  our  counsels,  and  given  heed  to  the 
teachings  of,  the  eugenists. 

SUMMARY  OF  THE  CHAPTER 

I.  For  centuries  the  Great  Black  Plague  —  syphilis  and 
gonorrhea  —  has  scourged  society  in  the  presence  of  the 


THE  GREAT  BLACK  PLAGUE         129 

silence-conspiracy  on  the  part  of  the  public,  the  church,  and 
the  medical  profession. 

2.  Columbus  discovered  syphilis  in  America  and  his  sailors 
carried  it  back  to  Europe.    Together  with  corn  and  tobacco 
it  represents  America's  contribution  to  civilization. 

3.  Syphilis,  while  usually  contracted  from  illicit  sex  rela- 
tions, can  also  be  picked  up  innocently  from  infected  cups, 
towels,  and  by  kissing. 

4.  Syphilis  is  probably  not,  technically  speaking,  inherited; 
although  a  child  may  be  born  with  congenital  syphilis  —  con- 
tracted from  its  infected  mother. 

5.  Syphilis  is  caused  by  a  parasite  (spirochaeta  pallida) 
and  runs  a  regular  course  from  the  time  of  infection  to  the 
later  and  severe  third  state  —  constitutional  manifestations. 

6.  Mild  syphilitic  infection  may  be  so  slight  in  the  early 
symptoms  as  entirely  to  escape  notice ;  but  yet  result  in  the 
most  formidable  later  manifestations. 

7.  The  Wassermann  test  if  properly  made  (though  not  in- 
fallible)  represents  the  best-known  method  of  determining 
trfe  presence  of  the  disease  in  doubtful  cases. 

8.  "  606  "  is  not  a  "  cure-all  "  for  syphilis ;  it  is  merely 
another  valuable  remedy  in  addition  to  the  old  mercury  stand- 
by and  the  iodids  in  the  later  stages  of  the  disease. 

9.  Most  insurance  companies  refuse  to  accept  untreated 
syphilitics ;  some  companies  require  extra  premiums  for  those 
accepted  even  after  treatment  and  often  refuse  to  keep  them 
on  their  books  after  55  years  of  age. 

10.  The  cure  of  syphilis  requires  persistent  and  intelligent 
treatment  over  a  period  of  years,  checked  by  the  Wassermann 
test  and  supervised  by  an  experienced  physician.     Marriage 
is  only  safe  after  such  a  scientific  course  of  treatment. 

11.  A  syphilitic  should  give  continuous  negative  Wasser- 
mann tests  at  least  two  years  before  getting  married. 

12.  Get  cured.    That  is  the  only  way  to  prevent  infecting 
an  innocent  wife;  to  prevent  having  a  stillborn  or  infected 
child;  and  to  avoid  locomotor  ataxia,  heart  disease,  or  soften- 
ing of  the  brain  in  later  life. 

13.  Gonorrhea  is  an  infection  of  the  mucous  membrane  by 
the  microbe  "  gonococcus."    It  is  usually  contracted  by  sex 
relations. 


130  RACE  DECADENCE 

14.  The  gonococcus  may  infect  the  eye,  producing  blind- 
ness; and  may  invade  the  blood,  producing  rheumatism.     It 
also  produces  sterility. 

15.  Gonorrhea  kills  about  one  person  in  200.    It  produces 
painful  strictures,  much  of  the  birth-blindness  of  babies,  and, 
most  of  the  surgical  operations  performed  upon  infected 
wives. 

1 6.  Gonorrhea  is  often  difficult  to  cure.     It  requires  per- 
sistent and  skilful  treatment.     It  is  a  crime  to  marry  until 
the  disease  is  pronounced  cured  by  a  competent  physician. 

17.  The  modern  treatment  of  gonorrhea  consists  of  three 
parts:  combating  the  local  infection,  gonococcus  vaccines, 
and  good  general  hygiene. 

1 8.  Neglected  gonorrhea  in  the  female  may  not  only  result 
in  sterility,  but  often  necessitates  a  surgical  operation  for  the 
removal  of  "  pus  tubes." 

19.  Soft  chancre  is  a  local  venereal  disease  without  any 
constitutional  symptoms.    When  mistaken  for  syphilis  it  may 
cause  much  needless  worry. 

20.  Much  of  the  prostatic  trouble  of  old  men  and  the 
"  female  complaints  "  of  women  owe  their  origin  to  venereal 
infection,  though,  of  course,  not  all. 

21.  Ninety  per  cent  of  syphilis  is  probably  acquired  from 
prostitutes.    Seventy-two  per  cent  of  prostitutes  have  at  least 
one  venereal  disorder. 

22.  Of  320  prostitutes  examined  (San  Francisco)  97  per 
cent  had  syphilis.    In  Detroit  94  per  cent  of  those  examined 
had  it. 

23.  It  is  estimated  that  there  are  1,000,000  prostitutes  and 
"  loose  women  "  in  this  country.    This  means  a  new  recruit 
every  8  minutes  —  200  every  night.    A  prostitute's  average 
length  of  life  is  about  five  years. 

24.  Stokes  thinks   that   about   4,000,000  persons   in   the 
United  States  have  had  syphilis.    In  one  hospital  70  per  cent 
of  the  women  treated  were  infected  by  their  husbands. 

25.  About  70  per  cent  of  all  the  work  done  by  specialists 
in  diseases  of  women  is  caused  by  gonorrhea. 

26.  Pinkus  estimates  one  man  in  five  in  Germany  has  had" 
syphilis.    Vedder  says  5  per  cent  of  West  Point  entrants  are 
infected. 


THE  GREAT  BLACK  PLAGUE         131 

27.  Pusey  thinks  5  per  cent  of  men  in  this  country  have 
syphilis,   i  per  cent  of  the  women,  and  about  3  per  cent 
of  the  entire  population. 

28.  Hough  estimates  10  per  cent  of  the  adult  males  in  this 
country  have  had  syphilis. 

29.  One  authority  says  gonorrhea  causes  50  per  cent  of  all 
gynecological  operations  on  women  and  25  per  cent  of  all 
blindness  in  this  country. 

30.  There  are  probably  5,000,000  cases  of  gonorrhea  in 
this  country  at  the  present  time. 

31.  Of  almost  800,000  young  men  reaching  maturity  each 
year  60  per  cent  (450,000)  contract  syphilis  or  gonorrhea 
before  they  are  30  years  of  age. 

32.  The  direct  and  indirect  economic  loss  to  the  country 
annually  from  venereal  diseases  is  over  $5,000,000,000. 

33.  We  must  fight  the  Black  Plague  by:  widespread  en- 
lightenment, better  sex-hygiene  teaching,  examinations  before 
marriage,  provision  for  prompt  and  skilful  treatment,  sup- 
pression of  advertising  quacks,  applying  common-sense  meth- 
ods*to  regulation,  and  teaching  our  youths  that  they  may  be 
clean  and  healthy  at  the  same  time. 

34.  Morality    is    hereditary.     Some    families    are   moral, 
others  are  inherently  immoral.    Eugenics  must  help  us  solve 
these  problems  of  vice  and  venereal  infection. 


CHAPTER  IX 
INCREASE  IN  "  OLD-AGE  "  DISEASES 

THE  fact  that  in  the  United  States  the  general  death- 
rate  has  steadily  fallen  for  the  past  several  decades, 
a  phenomenon  common  to  all  civilized  countries,  is  accepted 
by  many  as  evidence  of  a  steady  gain  in  national  vitality. 
That  there  has  been  a  gain  in  vitality  in  the  younger  age 
groups  is  unquestionably  true,  but  this  gain  has  served  to 
mask  a  loss  in  vitality  at  the  older  age  periods.  This  latter 
phenomenon,  a  rising  mortality  in  elderly  life,  is  something 
almost  peculiar  to  the  United  States.  It  is  not  exhibited  in 
the  mortality  statistics  of  any  of  the  leading  European 
countries. 

Rittenhouse  has  shown,  by  a  study  of  the  Massachusetts 
State  Registration  Reports,  that  between  1880  and  1909, 
a  period  of  thirty  years,  there  was  an  increase  of  nearly 
100  per  cent  in  the  mortality  from  degenerative  diseases. 
The  increase  at  each  age  is  shown  in  the  following  table : 


Ages 


1880 


1909      Increase  Per  Cent 


All  23.21 

Under  5  years 7.92 

5-9    2-95 

10-14  2.85 

15-19  3-10 

20-29  4.95 

30-39  10.13 

40-49  19-70 

50-59  39-or 


43.26 

10.36 

3-95 

4.72 

5-43 

8.09 

18.79 

37.84 

91.30 


20.05 

2.44 

1.04 

1.87 

2.33 

3-14 

8.66 

18.14 

52.29 


86.38 
30.8 
35-7 
65.6 
75-2 
63.4 
85-5 
92.1 
134-0 


60-69 


102.05        212.93        110.88        108.7 


70  and  over 261.10        558.20        297.10        113.0 

132 


INCREASE  IN  "OLD-AGE"  DISEASES  133 

DEGENERATIVE  DISEASES 

American  men  of  affairs  are  today  apparently  less  able 
to  stand  the  strain  of  modern  working  conditions  than  they 
were  thirty,  twenty,  or  even  ten  years  ago.  During  the 
past  ten  years  there  has  been  an  alarming  increase  in  the 
death-rate  from  "  old-age  "  diseases  —  heart  diseases,  arterio- 
sclerosis, Bright's  disease,  diabetes,  and  diseases  of  the 
digestive  and  nervous  systems  —  and  this  in  men  too  young 
to  succumb  to  these  old  men's  ailments.  This  increase  in  a 
group  of  5,000,000  occupied  men  in  this  country  was  as 
follows : 

Apoplexy  and  nervous  diseases 19  per  cent 

Heart  disorders   29  per  cent 

Kidney  and  urinary  diseases 43  per  cent 

Liver  and  digestive  disorders 34  per  cent 

During  the  past  thirty  years  the  mortality  from  these  de- 
generative diseases  has  nearly  doubled.  (See  Fig.  9.)  Of 
the  hundreds  of  thousands  of  American  lives  that  are  an- 
nually snuffed  out  by  these  "  old-age  "  disorders,  nearly  half 
die  befo're  their  time.  While  men  above  60  years  old  might 
be  said  to  succumb  to  them  normally,  almost  50  per  cent 
of  the  fatalities  recorded  are  of  men  under  60,  and  many 
thousands  of  them  die  under  40  —  and  these  are  diseases 
that,  whether  in  old  or  young,  can  be  prevented,  or  at  least 
postponed,  for  longer  or  shorter  periods,  if  the  facts  are 
known. 

WHAT  ARE  TIJESE  DEGENERATIVE  DISEASES? 

When  all  the  cells  of  the  human  body  act  in  a  normal 
manner,  when  nothing  is  present  to  irritate  or  destroy  them, 
when  each  little  separate  cell  is  healthy  in  body  and  properly 
performs  its  functions,  we  have  a  bodily  condition  known  as 
"  health."  When  the  cells  of  the  body  are  poisoned,  irri- 


1900 


1908 


1917 


1900 


1917 


160 
!40 


80 

60 
40 


14 


160 
140 
120 
100 
80 

60 

40 


KIDNEY 


HEART 


1900 


1908 


1917 


1900  1908 


1917 


160 
140 
120 
100 


80 


60 
40 


67.5 


ISO 


140 


CANCER 


Fig.  9.  Graphic  showing  increase  in  death-rates  from  the 
four  leading  diseases,  covering  a  period  of  eighteen  years. 
Figures  indicate  number  of  deaths  per  100,000  of  population 


INCREASE  IN  "OLD-AGE"  DISEASES  135 

tated,  or  otherwise  crippled  or  destroyed,  so  that  they  are 
unable  properly  to  perform  their  work,  some  form  of  acute 
or  chronic  disease  results.  (See  Fig.  10.)  The  basis, 
then,  of  all  disease  is  in  the  cell.  Organic  disease  results 
from  a  disorganization  or  derangement  in  the  physical 
structure  of  the  cell ;  while  functional  disease  results  from 
disturbance  of  the  functions  of  the  cell. 

Cells  are  often  long  sick  before  they  die.  When  cells  are 
very  sick  and  just  before  death,  they  sometimes  become  very 
granular  —  become  filled  with  minute  sandlike  particles.  In 
other  cases  the  cell  shows  a  disposition  to  imbibe  water  —  it 
swells  up  and  exhibits  numerous  vacuoles.  These  sick  cells 
may  later  undergo  complete  granular  disintegration,  a  process 
which  is  often  accompanied  by  the  formation  of  more  or  less 
fat.  One  of  the  most  common  causes  of  cell  death  is  chemi- 
cal poisoning  —  chemicals  taken  into  the  body  from  the  out- 
side, such  as  alcohol ;  chemical  substances  or  toxins  generated 
by  microbes  which  may  invade  the  body  in  disease ;  and  those 
chemical  poisons  which  are  normally  generated  within  the 
body  by  the  process  of  metabolism,  but  which  may  be  over- 
produced or  undereliminated. 

In  certain  diseases  and  in  old  age,  the  cells  of  different 
organs  in  the  body  undergo  atrophic  changes.  The  cell  sub- 
stance literally  withers  away  —  shrinks  up  —  and  the  tissues 
decrease  in  size,  while  their  functions  are  correspondingly 
destroyed. 

When  the  tissues  of  the  body  are  poisoned  severely,  the 
cells  of  many  of  the  internal  organs  begin  to  show  cloudy 
swelling,  a  form  of  granular  degeneration,  which  represents 
the  disorganisation  of  protoplasm.  (See  Fig.  10.)  These 
minute,  free  granules  are  albuminous  bodies  —  disintegrated 
protoplasm.  When  the  cells  of  the  heart  muscle  are  affected 
by  cloudy  swelling,  under  the  microscope  they  appear  as  if 
they  were  covered  by  a  fine  dust.  Recovery  from  cloudy 


136  RACE  DECADENCE 

swelling  is  possible  if  the  condition  is  not  allowed  to  progress 
too  far  or  to  last  too  long.  Fatty  degeneration  often  goes 
along  with  this  condition. 

DIFFERENT    SORTS    OF  CELL   DEGENERATION 

In  obesity  enormous  amounts  of  fat  may  be  deposited 
around  the  heart  and  other  organs,  but  this  fat  is  developed 
in  the  usual  manner  from  the  connective  tissue  cells.  In 
other  diseases,  the  muscle  tissues,  the  muscle  cells  of  the 
heart,  and  the  cells  of  other  organs  are  found  to  be  filled  up 
more  or  less  with  small  droplets  of  fat  —  fat  which  has  been 
made  from  the  protoplasm  of  the  muscle  or  other  cell.  This 
is  fatty  degeneration  and  is  a  serious  disease  of  the  cell, 
which,  when  it  has  become  established,  is  practically  incur- 
able. (See  Fig.  10.)  It  occurs  in  the  liver,  heart,  kidneys, 
and  also  in  the  epithelial  tissues. 

When  the  secretory  cells  found  in  the  glands  in  various 
parts  of  the  body  are  long  irritated  or  overworked,  as  in  the 
case  of  the  cells  in  the  glands  of  the  stomach  and  bowel,  in 
those  persons  who  partake  of  large  quantities  of  mustard, 
pepper,  vinegar,  etc.,  the  normal  cells  begin  to  disappear  and 
their  place  is  gradually  taken  by  cells  which  secrete  mucus 
in  the  place  of  the  regular  digestive  juices.  This  process  is 
mucous  degeneration  of  the  epithelial  cells.  (See  Fig.  10.) 

In  old  age  and  as  a  result  of  constant  irritation  and  long- 
continued  chemical  poisoning,  the  connective  tissues  of  the 
blood  vessels  may  undergo  amyloid  degeneration.  (See  Fig. 
10.)  This  amyloid  is  a  complex  starchlike,  albuminoid  sub- 
stance, which  becomes  deposited  in  the  connective  tissues, 
greatly  increasing  their  size.  This  condition  may  occur  in  any 
of  the  internal  organs.  Fatty  degeneration  is  often  associated 
with  amyloid  disease.  This  disease  of  the  cells  is  incurable. 
It  gradually  crowds  out  the  normal  elements  of  the  tissues, 
and  in  the  case  of  the  blood  vessels,  they  soon  lose  their 


CLOUDY  SWELLING  AND 
GRANULAR  DEGENERATION 


FATTY  DEGENERATION 


MUCUS  DEGENERATION 


AMYLOID  DEGENERATION 


Fig.  10.     Forms  of  cell  degeneration  in  the  human  body 


138  RACE  DECADENCE 

elasticity,  become  stiff,  and  later  are  hardened  by  the  deposi- 
tion of  lime  salts,  thus  producing  combined  arteriosclerosis 
and  arterial  degeneration. 

CELL  POISONS 

Of  all  the  causes  of  cell  death  which  are  under  our  control, 
that  of  poisoning  is  the  chief,  and  so,  before  finishing  our 
study  of  the  diseases  of  the  cell,  it  will  be  advisable  to  review 
the  many  poisonous  substances  which  are  able  to  cripple  or 
destroy  the  cells  of  the  body. 

1.  Impure  air. —  Bad  air  not  only  directly  impairs  the 
health  of  the  cells  of  the  lungs,  but  indirectly  interferes  with 
the  welfare  of  every  cell  in  the  body.    Smoke,  dust,  and  dirt 
in  the  air  may  actually  destroy  many  cells  in  the  lungs.    Dirty 
air  predisposes  to  the   contraction  of   tuberculosis,   pneu- 
monia, and  other  lung  diseases. 

2.  Contaminated  water. —  Impure  and  germ-laden  water  is 
able  to  destroy  the  life  of  the  cells  by  causing  many  diseases, 
such  as  typhoid  fever  and  dysentery. 

5.  Bad  food. —  Food  may  carry  microbes  or  parasites  into 
the  body,  or  it  may  be  decaying  and  hence  filled  with  danger- 
ous poisons  (ptomaines),  all  of  which  are  injurious  to  the 
health  of  the  cells.  Many  of  the  substances  commonly  used 
to  preserve  and  adulterate  foods  are  also  harmful  to  the  cells. 

4.  Metabolic  poisons. —  The    normal    poisons    which    are 
formed  in  the  body,  as  will  be  later  shown,  are  all  more  or 
less  poisonous  to  the  different  cells.    If  these  bodily  poisons 
are  not  promptly  eliminated,  or  if  they  are  overproduced,  the 
cells  must  suffer.     It  is  in  this  way  that  neglect  of  proper 
bathing,  deficient  exercise,  overeating,  constipation,  and  the 
drinking  of  too  little  water,  are  all  concerned  in  poisoning, 
crippling,  and  even  killing  the  cells  of  the  body. 

5.  Condiments. —  Certain   substances   commonly   used   as 
foods  or  relishes,  are  able,  when  used  in  large  quantities,  to 


INCREASE  IN  "  OLD-AGE  "  DISEASES  139 

cripple  and  weaken  the  cells.  Belonging  to  this  group  of 
agents  may  be  mentioned  vinegar,  mustard,  pepper,  and 
other  irritating  and  pungent  condiments.  Tea  and  coffee  are 
also  detrimental,  especially  to  the  nerve  cells.  The  concen- 
trated juices  of  animal  foods,  such  as  beef  tea,  weaken  the 
vitality  of  the  cells  in  the  stomach  and  bowel. 

6.  Tobacco  and  narcotics. —  Tobacco  is  a  poison  to  the  cells 
of  the  body,  especially  in  the  case  of  the  growing  body.    It 
destroys  the  cells  and  prevents  their  growth.    This  explains 
the  "  stunting "   effects  of   cigarette  smoking  upon  young 
boys.    It  is  especially  bad  when  the  smoke  is  inhaled.    Opium, 
morphine,  cocaine,  and  other  narcotic  drugs  all  behave  in  the 
same  manner,  and  must  be  regarded  as  dangerous  enemies  to 
health. 

7.  Alcohol. —  Of  all  the  cell  irritants,  or  poisons,  commonly 
used  by  man,  alcohol  undoubtedly  stands  as  the  chief  of  de- 
stroyers.   Careful  study  by  microscopic  examination  has  con- 
clusively proven  that  alcohol  is  a  cell  poison.    Alcohol  is  pro- 
duced by  the  action  of  the  yeast  plant,  and  it  is  found  to  be 
highly  poisonous  to  all  other  cells  or  organisms  which  are 
above  it  in  the  biologic  scale ;  that  is,  every  plant  or  animal 
which  is  higher  than  the  yeast  plant  in  the  scale  of  life, 
is  either  directly  injured  or  destroyed  by  alcohol. 

8.  Syphilitic  toxins  —  and  the  poisons  of  numerous  other 
microbic  and  parasitic  diseases  are  highly  injurious  to  the 
living  cells  of  the  human  body,  which,  when  long  exposed  to 
their  irritating  influence,  the  body  resents  by  a  reaction  which 
results  in  the  production  of  numerous  of  the  so-called  "  old- 
age  "  diseases. 

WHAT  IS  OLD  AGE? 

It  would  seem  to  appear  that  old  age,  then,  is  more  or  less 
the  result  of  chronic  poisoning  of  the  cells  of  the  body,  more 
particularly  affecting  the  cells  of  the  blood  vessels,  kidneys, 


140  RACE  DECADENCE 

heart,  etc.,  and  this  is  just  why  the  so-called  "  old-age  "  dis- 
eases which  we  have  discussed  in  this  chapter,  are  greatly  on 
the  increase  at  the  present  time,  instead  of  being  on  the  de- 
crease as  is  the  case  with  most  other  disorders  causing  death. 
Our  much-boasted  advancement  in  sanitation  and  public 
health  has  had  so  little  to  do  with  improving  personal  hygienic 
practices  of  the  people  —  in  fact  these  practices  have  become, 
it  would  seem,  gradually  more  and  more  pernicious,  so  that 
the  death-rate,  instead  of  being  improved,  has  been  alarm- 
ingly increased. 

A  more  detailed  consideration  of  the  individual  members 
of  this  group  of  "  old-age  "  diseases,  and  also  a  study  of  their 
causes  and  the  best  means  of  prevention,  will  be  discussed 
in  the  chapters  which  immediately  follow. 

Again,  attention  should  be  called  to  the  fact  that  longevity 
is  very  definitely  hereditary.  We  have  both  long-lived  and 
short-lived  families.  Eugenic  investigations  disclose  that 
there  exists  even  a  tendency  for  certain  of  these  so-called 
degenerative  diseases  to  "  run  in  families."  There  is  both 
a  constitutional  superiority  and  inferiority  which  is  trans- 
mitted from  one  generation  to  the  other,  in  accordance  with 
the  laws  of  human  inheritance.  The  biologists  claim  that  the 
general  ability  to  resist  disease  and  live  long  is  largely  a  mat- 
ter of  heredity. 

SUMMARY  OF  THE  CHAPTER 

1.  While  the  average  length  of  life  has  apparently  increased 
among  all  nations,  it  is  chiefly  during  the  earlier  years  of  life 
that  the  saving  has  been  made. 

2.  In  America  this  increase  in  the  earlier  years  is  to  some 
extent  offset  by  an  actual  decrease  in  the  older  age  periods. 

3.  Rittenhouse  claimed  that  the  degenerative  diseases  have 
increased  100  per  cent  in  Massachusetts  in  thirty  years. 

4.  In  a  certain  group  of  5,000,000  men  there  occurred  in 


INCREASE  IN  "OLD-AGE"  DISEASES  141 

ten  years  an  increase  in  kidney  disorders  of  43  per  cent,  and 
heart  disorder  29  per  cent. 

5.  The  basic  cause  of  these  "  old-age  "  or  degenerative  dis- 
orders is  chronic  irritation  or  poisoning  of  the  cells  of  the 
blood  vessels,  kidneys,  liver,  and  other  vital  organs;  thus 
bringing  about  destructive  changes  and  deterioration. 

6.  These  cell  poisons  are  numerous  and  include:  impure 
air,  bad  water,  contaminated   food,   self-poisoning    (auto- 
intoxication), high  seasoning,  tobacco,  alcohol,  and  the  tox- 
ins of  syphilis  and  other  microbic  diseases. 

7.  The  "  old-age  "  diseases  embrace  apoplexy,  paralysis, 
heart   disorders,   kidney   diseases    (Bright's   disease),  liver 
troubles,  high  blood-pressure  with  hardening  of  the  arteries, 
etc. 

8.  Public  sanitation  has  lengthened  the  lives  of  those  below 
40 ;  but  "  habit  disorders  "  are  increasingly  shortening  the 
lives  of  those  above  40  years. 

9.  These  "  old-age  "  diseases  are  largely  "  symptomless  " 
— ^that  is,  they  give  little  warning  of  their  presence. 

10.  These  diseases  are  called  degenerative  because  of  the 
fact  that  they  are  characterized  by  certain  cell  changes  such 
as :  fatty  degeneration,  mucous  degeneration,  amyloid  degen- 
eration, etc. 

1 1 .  Old  age  results  from  chronic  poison  and  long-continued 
overuse  of   the  bodily  structures  —  particularly  the  heart, 
liver,  kidneys,  and  arteries. 

12.  After  all,  inheritance  plays  an  important  role  in  our 
ability  to  resist  disease  and  live  long. 


CHAPTER  X 

HEART   FAILURE,  HARDENED  ARTERIES,  AND 
BRIGHT'S  DISEASE 

HEART  disorders,  arterial  sclerosis,  and  kidney  troubles 
represent,  with  their  consequences  of  apoplexy,  paraly- 
sis, etc.,  the  chief  disease  manifestations  of  premature  old 
age  that  have  to  do  with  crippling  the  efficiency  and  running 
up  the  mortality  rates  of  the  American  people.  We  have 
already  considered  such  other  important  causes  of  disease 
and  death  as  cancer,  tuberculosis,  venereal  infections,  to- 
gether with  pneumonia  and  influenza  —  diseases  which  are 
yet  to  be  conquered  —  although  we  have  not  discussed  dia- 
betes which  annually  claims  17  people  per  100,000  in  this 
country,  for  the  simple  reason  that  we  do  not  really  know 
how  to  classify  this  troublesome  disorder.  It  is  doubtful  if 
this  disease  belongs  to  the  degenerative  type.  While  it  is 
more  or  less  a  constitutional  disorder  and  not  a  kidney  ail- 
ment, nevertheless  there  remains  much  to  be  learned  about 
its  causation. 

HEART  DISEASES  INCREASING 

While  there  are  many  forms  of  heart  disease  which  are 
responsible  for  the  death-rate  that  might  be  charged  up  to 
heart  disorders,  the  one  that  concerns  us  most  is  heart  fail- 
ure —  failure  of  the  blood-pump  owing  to  arterial  degenera- 
tion and  its  consequent  high  blood-pressure. 

When  the  blood-pressure  steadily  mounts  upward,  eventu- 
ally one  of  two  things  happens:  either  the  heart  —  the 
pump  —  will  give  way,  or  the  blood  vessels  —  the  more  or 

142 


HEART  FAILURE,  B RIGHT'S  DISEASE  143 

less  hardened  arteries  —  connected  with  the  pump,  will  burst. 
This  bursting  of  the  blood  vessels  usually  takes  place  in  the 
brain  and  is  popularly  known  as  a  "  stroke  "  of  apoplexy,  and 
the  resulting  paralysis  on  one  or  both  sides  of  the  body  is  due 
to  the  pressure  of  the  accumulating  blood  clot  on  the  brain 
centers.  During  the  last  year  for  which  we  have  official 
reports  there  were  198.4  deaths  per  100,000  of  population  in 
the  United  States  from  heart  disorders,  the  highest  death- 
rate  for  any  disease.  It  means  that  in  one  year  practically 
one  person  out  of  every  500  died  of  some  form  of  heart 
disease. 

Furthermore,  this  rate  increased  from  159  to  198.4  in  ten 
years.  No  other  cause  of  death  is  mounting  with  comparable 
rapidity.  Since  very  few  persons  less  than  40  years  of  age 
die  with  heart  disease,  and  since  both  the  heavy  death-rates 
and,the  larger  populations  are  in  the  younger  years,  the  heavy 
heart  disease  rate  means  that  the  chance  that  any  man  over 
40  will  pass  away  from  heart  disease  is  very  great. 

OUR  LIVING  PUMP 

The  heart  is  a  hollow,  muscular  organ  about  the  size  of  the 
fist.  It  consists  of  four  compartments,  two  on  either  side. 
The  heart  muscle  fibers  are  peculiar  to  themselves,  resembling 
both  voluntary  and  involuntary  muscle.  The  two  lower  and 
larger  chambers  of  the  heart  are  called  ventricles.  The  upper 
and  smaller  chambers  are  called  auricles.  The  heart  contains 
four  sets  of  valves  which  guard  the  openings  between  its  vari- 
ous chambers,  as  well  as  the  large  vessels  leading  to  the  lungs 
and  the  general  circulation. 

The  blood  vessels  consist  of  arteries,  veins,  and  capillaries. 
The  arteries  carry  the  blood  away  from  the  heart  to  various 
parts  of  the  body,  and  consist  of  three  distinct  layers :  a  deli- 
cate inner  lining,  called  endothelium,  with  middle  and  outer 
layers  of  muscular,  elastic,  and  connective  tissue.  The  capil- 


144  RACE  DECADENCE 

laries  are  a  system  of  small  blood  vessels  which  connect  the 
arteries  with  the  veins.  Like  the  arteries,  they  possess  con- 
tractile power.  Arteriosclerosis,  or  hardening  of  the  arteries, 
means  that  the  delicate  lining  of  the  blood  vessels  has  been 
chronically  irritated  so  that  a  low-grade  inflammation  has 
been  set  up  which  has  resulted  in  increasing  the  connective 
tissue  in  the  middle  layer  —  all  of  which  results  in  stiffening, 
and  with  the  later  deposition  of  lime  salts  —  terminates  in 
hardening. 

All  the  blood  of  the  body  (or  a  volume  equal  thereto) 
passes  through  the  heart  every  minute.  The  arteries  —  the 
blood  vessels  leading  out  from  the  heart  —  have  been  esti- 
mated to  represent  a  length  of  about  1,000  miles.  The  skin 
is  richly  supplied  with  capillaries  containing  about  10,000 
square  feet.  The  heart  does  a  work  every  twenty-four  hours 
equal  to  lifting  about  124  tons  one  foot  high. 

EARLY  SYMPTOMS  OF   HEART  DISEASE 

Most  of  the  groundwork  for  heart  disease  is  laid  down  in 
childhood.  When  young  adults  are  systematically  examined, 
as  is  done  now  on  entrance  to  college,  it  is  found  that  a  large 
proportion  have  heart  murmurs.  These  subjects  deny  that 
they  have  ever  had  heart  disease  or  that  they  have  any 
symptoms  of  it  at  the  time  of  examination.  When  closely 
questioned,  they  tell  of  having  had  tonsilitis,  rheumatism,  or 
St.  Vitus'  dance,  or  some  eruptive  disease,  but  they  thought 
recovery  had  been  complete. 

The  early  symptoms  of  heart  disease  are: 

1.  Shortness  of  breath.     Inability  to  get  one's  "second 
wind  "  as  readily  as  the  average  person. 

2.  Swelling   of   the   ankles  —  particularly  if   the  ankles 
"  pit "  on  pressure.    This  swelling  is  more  prone  to  appear 
in  the  evening. 

3.  Rapid,  palpitating,  or  thumping  heart.     These  symp- 


HEART  FAILURE,  BRIGHT'S  DISEASE  145 

toms  may  or  may  not  be  an  evidence  of  heart  trouble  — 
they  may  arise  from  nervousness  or  indigestion,  but  they 
should  be  investigated. 

4.  Pain  in  the  region  of  the  heart  —  especially  if  it  is  se- 
vere and  "  vicelike."  In  persons  over  50  years  of  age  this 
may  indicate  the  coming  on  of  angina  pectoris. 

There  are  certain  symptoms  which  cause  many  people  to 
think  they  have  heart  disease,  but  which  no  one  should 
worry  about.  Among  these  are: 

1.  Pains  in  the  chest  and  particularly  around  the  heart. 

2.  False  angina  or  radiating  pains  around  the  chest  and 
down  the  arm  occurring  in  persons  under  40  years  of  age. 

3.  Palpitation  of  heart  not  following  exertion. 

4.  Coldness  of  the  hands  and  feet,  feeling  of  numbness  or 
"  going  to  sleep  "of  the  hands  and  feet,  ordinary  dizziness 
and  "  swimming  of  the  head,"  rushing  of  blood  to  the  head, 
hearing  the  heart  pound  in  the  ears  or  feeling  it  pulsate  in 
the  abdomen. 

Most  of  these  symptoms  are  of  no  great  significance. 
They  do  not  indicate  heart  disease. 

VALVULAR  DISEASE 

Mitral  stenosis  is  most  common  in  women.  In  this  dis- 
order there  is  a  narrowing  of  the  opening  between  the  two 
cavities  on  the  left  side  of  the  heart.  Those  who  have  this 
form  of  heart  trouble  get  out  of  breath  very  easily  and  are 
able  to  work  at  only  such  tasks  as  stenography,  operating 
switchboards,  secretaryships,  etc.  A  man  so  affected  might 
do  many  sorts  of  office  or  professional  work. 

Mitral  regurgitation  is  the  name  given  to  that  condition 
where  this  passage  between  the  two  cavities  of  the  left  side 
of  the  heart  is  too  large  for  the  valve  to  close  it  properly. 
This  form  of  heart  disorder  probably  causes  the  least  trouble 
as  compared  with  other  sorts  of  valvular  disorders.  Men 


146  RACE  DECADENCE 

have  this  form  of  heart  ailment  more  than  women.  Persons 
with  this  affliction  work  at  the  professions  'and  at  most  of  the 
trades  which  do  not  require  sudden  "  spurts  "of  effort. 
Properly  managed,  this  form  of  heart  disease  should  not 
tend  to  shorten  life. 

Aortic  regurgitation  is  a  condition  in  which  the  passage 
leading  from  the  ventricle  to  the  aorta  is  too  large  —  so  that 
the  blood  runs  back  into  the  heart.  Patients  with  this  trou- 
ble can  do  light  gardening,  conduct  stores,  etc.  Those  who 
suffer  from  aortic  stenosis  —  narrowing  of  this  passageway 
leading  to  the  aorta  —  cannot  do  much  real  work  unless  the 
heart  is  compensated. 

Whatever  the  form  of  the  heart's  valvular  disorders,  the 
patient  cannot  do  much  work  or  stand  much  physical  effort 
unless  the  heart  is  compensated.  Compensation  means  sim- 
ply that  the  heart  muscle  as  a  whole  has  so  enlarged  that  it 
can  do  the  extra  work  required  to  overcome  these  results  of 
valvular  leaks  (regurgitation),  or  narrowing  of  the  openings 
between  the  chambers  of  the  heart  (stenosis).  When  com- 
pensation is  perfect  a  heart  patient  can  go  about  ordinary 
work  and  activities  just  about  as  though  nothing  was  wrong. 
The  person  with  heart  disease  of  that  type  can  live  just  as 
long  as  other  persons  of  his  age  if  he  will  follow  certain  sim- 
ple rules.  Heart  disease  is  a  disease  to  be  lived  with,  and  it 
is  not  difficult  to  learn  how. 

If  compensation  is  broken,  the  subject  must  rest  until  it 
has  been  reestablished.  In  most  cases  it  is  necessary  to  go  to 
bed  and  to  stay  there  a  long  time  to  reestablish  compensation. 

HIGH  BLOOD-PRESSURE 

As  regards  health  and  disease,  the  most  important  item 
connected  with  the  study  of  the  circulation  is  the  subject  of 
blood-pressure.  We  have  only  recently  come  to  understand 
how  important  this  question  is  in  its  relation  to  health. 


HEART  FAILURE,  BRIGHT'S  DISEASE  147 

The  evil  results  of  this  high  pressure  will  be  considered 
before  we  take  up  the  causes.  They  may  be  enumerated  as 
follows : 

1.  Arteriosclerosis. —  High  blood-pressure  is  one  of  the 
recognized   causes    of    arteriosclerosis  —  degeneration    and 
hardening  of  the  arteries ;  and  arteriosclerosis  is  the  real 
cause  of  old  age,  or  senile  degeneration.     Let  us  remember 
this  vicious  circle :    Hardened  arteries  raise  the  blood-pres- 
sure —  and  high  blood-pressure  tends  further  to  harden  the 
arteries. 

2.  Apoplexy. —  Since  high  blood-pressure  is  one  of  the 
causes  of  hardening  of  the  arteries,  it  then  becomes  apparent 
that  it  is  the  indirect  cause  of  apoplexy,  for  this  is  merely  a 
rupture  of  the  small  arteries  in  the  brain,  which  are  unable 
to  withstand  the  enormous  pressure  required  in  order  to  force 
the*blood  through  the  stiff  and  shrunken  vessels. 

5.  Bright' s  disease. —  This  is  a  condition  in  which  the  ar- 
teries of  the  kidneys  are  shriveling  up  as  the  result  of  poisons 
and  high  blood-pressure.  This  disease,  with  its  attendant 
evils  of  dropsy  and  heart  failure,  is  also  largely  attributable 
to  high-pressure  influences. 

4.  Heart  failure. —  It  must  be  apparent  that  if  the  blood- 
pressure  is  to  be  constantly  increased  in  order  to  nourish  the 
body  and  overcome  the  growing  resistance  of  hardening  ar- 
teries, the  heart  —  the  blood-pump  —  will  be  called  upon  to 
exert  increased  force;  and  this  it  does,  by  hypertrophy,  until 
by  and  by  the  walls  are  overstretched,  the  heart  becomes 
permanently  dilated,  and  when  the  end  comes,  it  is  called 
"  heart  failure." 

5.  Certain  mental  diseases  —  are  also  indirectly  produced 
or  influenced  by  high  or  low  blood-pressure,  such  as  mania, 
melancholy,  etc.,  as  well  as  ordinary  nervousness,  sleepless- 
ness, and  many  common  everyday  maladies.    High  pressure 
may  be  both  a  cause  and  a  result  of  disease. 


148  RACE  DECADENCE 

CHRONIC  KIDNEY  DISORDERS 

There  are  many  forms  of  acute  inflammation  of  the  kid- 
ney, and  its  resultant  injury  to  that  organ,  as  well  as  numer- 
ous chronic  degenerative  conditions,  due  mainly  to  harden- 
ing of  the  arteries.  These  kidney  disorders  are  commonly 
known  as  Bright's  disease,  and  while  it  may  be  a  local  dis- 
ease in  some  instances,  it  usually  is  associated  with  degenera- 
tion or  hardening  of  the  blood  vessels,  and  both  the  heart 
and  liver  are  usually  more  or  less  involved.  In  the  last  year 
for  which  we  have  official  reports,  there  were  107.4  deaths 
per  100,000  of  population  from  kidney  disorders  in  the 
United  States.  Kidney  disorders  have  increased  20.7  in  the 
registration  area  since  1900. 

The  kidney  is  divided  into  numerous  compartments,  each 
containing  vast  numbers  of  excreting  tubules  which  are 
lined  with  epithelium,  and  whose  general  structure  much  re- 
sembles that  of  the  skin.  Arteries  and  veins  are  liberally 
supplied,  and  as  the  blood  circulates  through  these  vessels, 
certain  poisons  found  in  the  blood-stream  are  selected  by  the 
kidney  and  excreted  (really  secreted)  through  its  walls  into 
the  urinary  tubules,  which  carry  the  urine  through  the  ure- 
ters to  the  bladder.  It  is  the  chronic  inflammation  of  these 
urinary  tubules  that  causes  nephritis,  or  Bright's  disease.  It 
has  been  estimated  that  the  urinary  tubules  of  the  kidneys, 
if  all  were  united  end  to  end,  would  form  a  single  drainage 
tube  over  15  miles  in  length. 

The  skin  is  closely  related  to  the  kidneys  in  the  mode  of 
eliminating  poisons  from  the  body  and  when  the  kidneys  are 
in  any  way  crippled  as  a  result  of  disease,  the  skin  may  be 
made  to  do  extra  eliminating  work  and  thus  help  out  the  kid- 
neys. The  average  person  possesses  about  17  square  feet  of 
skin.  It  is  estimated  that  there  are  2,500,000  sweat  glands 
in  the  skin.  The  area  of  the  openings  of  all  these  little  sweat 


HEART  FAILURE,  BRIGHT'S  DISEASE  149 

glands  is  about  11,000  square  feet.  That  is,  the  body's 
sewer  system  which  has  its  openings  in  the  sweat  glands  of 
the  skin,  if  represented  by  a  single  eliminating  tube  with  but 
one  opening,  would  have  an  emptying  or  discharging  sur- 
face equal  to  11,000  square  feet.  In  many  parts  of  the 
body  there  are  about  2,500  little  sweat  pores  to  the  square 
inch;  while  the  uniting  of  all  the  sweat  ducts,  end  to  end, 
which  are  coiled  up  in  the  skin,  thus  making  a  single  tube, 
would  make  a  sewer  more  than  10  miles  long. 

OVERWORKING  THE  KIDNEYS 

The  kidneys  excrete  a  portion  of  the  water  contained  in- 
the  blood,  in  the  effort  to  keep  the  blood  at  the  proper  con- 
sistency. They  maintain  the  balance  in  the  water  supply  of 
the  body,  consequently  the  more  one  sweats,  the  less  urine 
wilj  be  passed.  A  decrease  in  the  amount  of  water  drunk 
will  also  decrease  the  urine.  The  color  of  the  urine  varies 
from  day  to  day.  In  health  it  is  something  of  a  straw 
color.  Urinary  deposits,  as  ordinarily  observed,  are  mean- 
ingless. They  sometimes  represent  grave  disease;  but  on 
the  other  hand,  healthy  urine,  if  allowed  to  stand  when  con- 
taining certain  elements,  will  present  deposits  of  brick-dust 
appearance. 

The  kidneys  are  greatly  injured  and  overworked  by  the 
eating  of  too  much  protein  —  such  substances  as  meat,  dried 
beans,  and  cheese.  Protein  ashes  must  be  eliminated  through 
the  kidneys.  Alcohol,  tobacco,  and  other  narcotics,  also 
greatly  overtax  and  prematurely  wear  out  the  kidneys. 
Bright's  disease  is  manifested  where  these  organs  have 
been  long  overworked,  inflamed,  and  so  worn  out  as  the 
result  of  abuse,  that  they  are  unable  to  do  their  normal 
work. 

Failure  to  drink  regularly  a  proper  amount  of  water  allows 
the  urine  to  become  high-colored  and  concentrated;  this  is- 


150  RACE  DECADENCE 

very  irritating  to  the  kidneys,  and  no  doubt  results  in  more 
or  less  injury  to  these  organs.  The  health  of  the  kidneys, 
therefore,  depends  upon  the  cultivation  of  the  regular  water- 
drinking  habit. 

NEPHRITIS A  SYMPTOMLESS  DISEASE 

Of  all  the  degenerative  or  "  old-age  "  disorders,  chronic 
Bright's  disease  is  the  most  stealthy.  A  middle-aged  man 
or  woman  can  be  within  a  few  weeks  or  months  of  the  grave 
and  be  quite  unaware  of  their  doom.  A  vast  number  of  these 
chronic  kidney  cases  never  produce  serious  or  alarming 
symptoms  until  their  victims  are  very  near  their  end.  This 
is  the  reason  we  urge  everybody  to  submit  to  an  annual  med- 
ical examination.  Years  before  any  discernible  symptom 
would  have  appeared,  the  careful  examination  of  the  urine 
together  with  the  blood-pressure  findings  would  have  served 
to  indicate  the  slowly  oncoming  kidney  disorder  —  and 
would  have  pointed  out  the  trouble  in  time  to  have  done 
something  effectual  about  it. 

A   FRIGHTFUL  DEATH   TOLL 

Over  400,000  persons  die  each  year  in  this  country  from 
these  so-called  "  old-age  "  diseases  —  heart  disorders,  arte- 
rial degeneration,  and  kidney  diseases.  The  actual  number  of1 
deaths  from  these  combined  diseases  and  their  indirect  conse- 
quences cannot  be  far  from  half  a  million  each  year  when 
we  consider  that  for  every  100,000  of  population  heart  dis- 
orders claim  198.4;  Bright's  disease  and  kidney  disorders 
118.5;  cerebral  hemorrhage  (apoplexy)  99.8,  and  cirrhosis 
of  the  liver  11.4;  making  a  grand  total  of  428.1  annual 
deaths  per  100,000. 

The  only  group  of  diseases  which  can  compare  with  this 
frightful  loss  is  the  respiratory  group  —  tuberculosis,  pneu- 
monia, influenza,  bronchitis,  etc.  Per  100,000  of  population 


HEART  FAILURE,  BRIGHT'S  DISEASE  151 

this  group  has  a  death-rate  as  follows :  pulmonary  tubercu- 
losis 128.7;  pneumonia  164.8;  influenza  17.2;  bronchitis 
16.3,  yielding  a  grand  total  for  this  group  of  lung  disorders 
of  327  per  100,000. 

If  we  count  the  liver  disorders  and  numerous  other  causes 
of  death  indirectly  related  to  these  degenerative  disorders,  it 
is  highly  probable  that  the  annual  death-rate  is  very  close  to 
500,000  for  the  entire  group  of  degenerative  diseases.  About 
65,000  citizens  die  of  these  "  old-age  "  disorders  before  they 
are  50  years  of  age ;  and  almost  30,000  die  before  they  are  40 
years  old. 

And  these  disorders  are  not  like  cancer  —  we  know  the 
causes  to  a  great  extent  and  know  what  to  do  in  most  every 
case  to  prolong  life.  Has  not  the  time  about  arrived  to  make 
a  concerted  attack  on  this  particular  group  of  our  disease 
enemies  ? 

SUMMARY  OF  THE  CHAPTER 

1.  The  cardio-vascular  disorders  with  their  accompanying 
high  blood-pressure  and  resultant  apoplexy,  paralysis,  etc., 
represent  the  chief  diseases  of  premature  old  age. 

2.  When  the  blood-pressure  continues  to  rise,  eventually, 
one  of  two  things  is  bound  to  happen,  either : 

a.  The  heart  (the  pump)  will  fail,  or 

b.  The  arteries  will  burst. 

3.  In  the  first  case  death  results  from  heart  failure,  in  the 
second,  apoplexy  is  followed  by  paralysis  and  death  sooner  or 
later. 

4.  During  the  last  year  reported,  nearly  200  persons  per 
100,000  died  of  heart  diseases  in  this  country. 

5.  The  death-rate  from  heart  failure  has  increased  from 
159  to  198.4  per  100,000  in  ten  years. 

6.  Hardened  arteries  result  from  the  chronic  irritation  of 
the  delicate  lining  of  the  blood  vessels  from  long-continued 
poisoning. 

7.  Blood  equal  to  the  total  volume  passes  through  the  heart 


152  RACE  DECADENCE 

every  minute;  and  all  blood  vessels  in  the  body,  if  placed 
end  to  end,  would  reach  1,000  miles. 

8.  There  are  10,000  square  feet  of  capillaries  in  the  skin. 
The  heart,  every  twenty-four  hours,  does  the  work  of  lifting 
124  tons  one  foot  high. 

9.  The  early  symptoms  of  heart  disease  are:    shortness 
of  breath ;  swelling  of  the  ankles ;  rapid  heart ;  and  pain  in 
the  region  of  the  heart. 

10.  There  are  symptoms  which  frighten  people  into  fear 
of  heart  trouble  such  as :  pains  in  chest ;  palpitation,  due  to 
gas ;  cold  hands  and  feet ;  numbness ;  dizziness ;  "  swimming 
of  the  head ;"  etc. 

11.  Persons  with  valvular  heart  trouble  may  work  at  light 
tasks   but  cannot  engage  in  sudden  "  spurts "   of    effort. 
Heart  cases  can  do  much  light  work  after  "  compensation  " 
is  established. 

12.  If  "  compensation  "  is  broken,  the  patient  must  rest  in 
bed  until  it  is  reestablished. 

13.  The  one  thing  characteristic  of  the  present-day  social 
and  commercial  world  is  its  high  tension.     The  pressure 
gauge  of  life  registers  all  the  while  dangerously  near  the 
bursting-point. 

14.  High  blood-pressure  is  not  only  a  result  of  the  degen- 
erative diseases,  but  may  also,  in  turn,  be  a  cause  for  the 
further  hardening  of  the  arteries. 

15.  Chronic  kidney  disorders,  as  a  group,  are  popularly 
known  by  the  name  of  Bright's  disease.    And  these  disorders 
have  increased  20.7  per  cent  in  this  country  since  1900. 

1 6.  The  skin  is  closely  related  to  the  kidney  in  the  work 
of  elimination  and  may  thus  be  made  to  help  out  a  diseased 
pair  of  kidneys. 

17.  There  are  17  square  feet  of  skin  with  2,500,000  sweat 
glands.    The  total  area  of  the  mouths  of  these  glands  is  about 
11,000  square  feet;  united,  these  sweat  tubes  would  make  a 
sewer  10  miles  long. 

1 8.  Urinary  deposits,  as  ordinarily  observed,  are  mean- 
ingless.    Sometimes  they  represent  grave  disease;  on  the 
other  hand,  healthy  urine  shows  deposits  under  certain  con- 
ditions. 

19.  The  kidneys  are  overworked  by:  too  much  protein, 


HEART  FAILURE,  BRIGHTS  DISEASE  153 

alcohol,  tobacco,  and  other  irritating  substances,  such  as  the 
acids  of  the  body  and  the  toxins  of  disease. 

20.  The  kidneys  are  greatly  injured  and  irritated  by  fail- 
ure to  drink  a  proper  amount  of  water  each  day. 

21.  Nephritis  (Bright's  disease)  is  largely  a  "symptom- 
less  "  disease;  and  this  is  just  why  everyone  should  be  ex- 
amined once  a  year. 

22.  Almost  500,000  die  in  this  country  each  year  from  this 
group  of  "old-age"  disorders;  65,000  die  before  50;  and 
30,000  before  they  are  40  years  old. 


CHAPTER  XI 
CAUSES  OF  "OLD-AGE"  DISORDERS 

HAVING  studied  the  degenerative  diseases  as  a  class 
and  also  noted  something  of  their  individual  influence 
in  increasing  the  mortality  of  the  American  people,  it  is  alto- 
gether fitting  at  this  juncture  to  summarize  the  causes  of  the 
various  "  old-age  "  disorders.  These  causes  may  be  classi- 
fied under  the  following  heads : 

i.  The  habitual  use  of  drugs  —  alcohol,  tobacco,  patent 
medicines,  headache  powders,  together  with  the  excessive  use 
of  tea  and  coffee. 

It  must  be  borne  in  mind  that  one  ordinarily  feels  lan- 
guid, depressed,  and  good  for  nothing,  when  the  blood- 
pressure  is  too  low;  whereas  one  usually  feels  exhilarated 
and  tiptop  when  the  blood-pressure  is  high ;  therefore,  there 
is  a  constant  tendency  to  make  use  of  those  things  which  in- 
crease the  blood-pressure,  or  in  cases  suffering  from  low 
pressure,  to  resort  to  the  use  of  high-pressure  producers  to 
counteract  the  unpleasant  low-pressure  effects. 

Tobacco  stands  foremost  among  the  common  causes  of 
increased  blood-pressure  —  and  of  premature  "  old-age  "  dis- 
orders. It  is  well  known  that  when  a  young  man  takes  his 
first  smoke,  he  is  pale  in  the  face,  the  small  blood  vessels  of 
the  skin  are  strongly  contracted ;  the  blood  is  thus  forced  in 
upon  the  internal  organs.  The  blood-pressure,  if  taken  at 
such  a  time,  is  found  to  be  considerably  raised ;  and  so 
throughout  life  the  effect  of  tobacco  using,  due  to  the  spe- 
cific action  of  the  nicotine  and  other  poisons,  is  that  of  di- 
rectly raising  the  blood-pressure.  (A  single  cigar  raises 

154 


CAUSES  OF  "OLD-AGE"  DISORDERS  155 

blood-pressure  for  over  one  hour.)  The  use  of  tobacco,  then, 
may  be  regarded  as  one  of  the  prominent  causes  of  increased 
blood-pressure  in  the  present  generation,  and  of  many  of  the 
serious  dangers  and  consequences  following,  namely,  de- 
ranged nervous  system,  hardened  arteries,  kidney  trouble, 
heart  failure,  and  apoplexy. 

The  cigars  smoked  each  year  in  this  country,  laid  end  to1 
end,  would  reach  considerably  over  halfway  to  the  moon.  It 
is  safe  to  estimate  that  there  were  smoked  of  cigarettes,  to 
say  nothing  of  cigars,  an  average  of  5,000  for  every  young 
man  in  the  United  States  between  the  ages  of  12  and  20  years. 

The  American  people  spend  more  money  every  year  for 
tobacco  than  for  bread.  This  will  give  some  idea  of  the 
enormous  consumption  of  this  poisonous  weed,  and  throws 
much  light  on  one  of  the  causes  of  the  increase,  in  recent 
years,  of  "  old-age  "  disorders. 

There  is  a  single  tobacco  company  that  has  a  capacity  for 
making  about  10,000,000  cigarettes  a  day. 

Last  year  the  American  people  smoked  46,680,317,081  cig- 
arettes—  ready  made  —  to  say  nothing  of  how  many  were 
made  by  the  smoker  himself  from  paper  and  tobacco.  Ten 
years  before  only  6,836,652,435  cigarettes  were  used,  show- 
ing an  increase  of  almost  40,000,000,000  cigarettes  in  less 
than  ten  years.  Laid  end  to  end  the  cigarettes  used  last 
year  would  reach  around  the  world  thirty  times.  In  addition 
to  all  this  we  consume  about  8,000,000,000  cigars  every  year. 
This  does  not  take  into  account  the  chewing  tobacco  con- 
sumed nor  the  millions  of  pounds  of  snuff  which  is  used  each 
year.  Cigarettes  were  only  introduced  in  1876.  Their  use 
has  steadily  increased. 

From  data  obtained  not  long  ago  from  the  United  States 
Census  Bureau  and  other  reliable  sources,  the  average  daily 
dose  of  poisons  for  every  man,  woman,  and  child  in  the 
United  States  is  found  to  be  356  grains  of  alcohol,  6  grains  of 


156  RACE  DECADENCE 

nicotine,  6  grains  of  caffein,  and  1.5  grains  of  opium  aggre- 
gating nearly  364  grains.  The  influence  of  such  an  enor- 
mous quantity  of  drugs  must  make  itself  felt  in  the  develop- 
ment of  a  host  of  neurotics  to  crowd  our  hospitals  and  asy- 
lums and  fill  premature  graves. 

The  caffeine  of  coffee  and  the  theine  of  tea  are  narcotic 
poisons  which  exert  a  direct  influence  in  elevating  the  blood- 
pressure  when  taken  into  the  system.  They  are  very  properly 
discussed  under  the  head  of  "  Drug  Causes,"  notwithstanding 
the  fact  that  they  are  so  commonly  used  as  beverages  in 
connection  with  meals. 

Tea  and  coffee  are  freely  used  even  by  young  children 
with  tender  nervous  systems.  We  have  "  tea-drinkers'  "  dis- 
order, which  is  a  disease  recognized  by  the  medical  profes- 
sion ;  and  tea  topers  are  found  among  both  men  and  women. 
This  tea  and  coffee  drinking  is  none  the  less  a  case  of  drug 
addiction,  even  though  it  be  taken  at  mealtime,  and  notwith- 
standing the  fact  that  their  use  has  become  well-nigh  uni- 
versal. There  is  used  in  the  United  States  a  billion  and  a 
quarter  pounds  of  tea  and  coffee  a  year;  (1,227,736,620 
pounds,  last  report).  This  is  almost  twelve  pounds  of  tea 
and  coffee  a  year  for  every  man,  woman,  and  child  in  the 
country.  The  United  States  coffee  bill  is  about  $150,000,000 
a  year. 

2,  Venereal  diseases. —  Syphilis,  as  in  the  case  of  chronic 
lead  poisoning,  is  one  of  the  great  causes  of  early  arterial 
degeneration. 

j.  Dietetic  errors  —  habitual  overeating  (three  square 
meals  a  day),  overflavoring  of  food,  too  highly  seasoned 
food  —  foods  that  are  "  hot  "  when  they  are  cold.  Over- 
eating is  especially  contributory  to  these  degenerative  dis- 
orders when  it  consists  in  taking  too  much  of  the  protein 
foods  —  lean  meats,  eggs,  cheese,  legumes,  etc. 

It  has  been  shown  that  the  free  use  of  all  the  condiments 


CAUSES  OF  "OLD-AGE"  DISORDERS  157 

which  are  commonly  used  by  Americans,  with  the  exception 
of  small  amounts  of  common  table  salt,  nutmeg,  and  cinna- 
mon, tend  to  have  a  harmful  effect  on  the  liver,  blood  vessels 
and  kidneys  to  say  nothing  of  their  deleterious  effects  upon 
the  digestive  system.  Those  condiments  which  may  in  this 
indirect  way  increase  the  blood-pressure  are  mustard,  pepper, 
vinegar,  cayenne,  horseradish,  and  the  other  pungent  season- 
ing substances.  Overseasoning  leads  to  overeating  —  and 
overeating  is  one  of  the  great  causes  of  "Americanitis  "  — 
the  premature  appearance  of  "  old-age  "  or  degenerative  dis- 
orders. 

Common  table  salt  (sodium  chlorid)  is  not  by  any  means 
an  innocent  substance  when  used  excessively.  Many  au- 
thorities hold  the  opinion  that  the  modern  "  salt  habit "  — 
the  tendency  of  so  many  persons  to  consume  more  and  more 
salt  on  their  food  as  the  years  go  by  —  has  considerable  to  do 
wim  the  increase  in  kidney,  heart,  and  liver  disorders.  The 
author  shares  this  belief  to  a  certain  extent  and  thinks  it  a 
wise  policy  to  watch  one's  taste  for  condiments  in  general 
and  salt  in  particular  —  especially  after  one  gets  to  be  30 
years  of  age  and  over.  Try  to  form  the  habit  of  eating  a. 
little  less  salt  —  instead  of  a  little  more. 

Let  us  avoid  the  cultivation  of  an  artificial  taste  —  a  false 
appetite.  Better  go  slowly  with  encouraging  the  increased 
consumption  of  "  foods  that  taste  '  hot '  when  they  are  cold." 

The  American  people,  in  common  with  their  English 
cousins,  .consume  enormous  quantities  of  the  flesh  of  animals 
for  food.  We  eat  too  much  meat  in  this  country.  All  forms 
of  flesh  food  contain  certain  irritating  substances,  such  as 
uric  acid  and  its  numerous  chemical  cousins,  which  were  cir- 
culating through  the  flesh  of  the  animal  at  the  instant  of 
death,  and  which  are  swallowed  along  with  the  meat,  and 
have  the  power  to  raise  the  blood-pressure  considerably 
(when  eaten  excessively),  by  their  irritating  effect  upon  the 


158  RACE  DECADENCE 

tender  linings  of  the  blood  vessels,  and  their  further  probable 
influence  upon  the  nervous  system. 

The  overuse  of  meat  as  a  daily  food  is  still  further  objec- 
tionable from  the  standpoint  of  preventing  premature  "  old- 
age  "  disorders  because  of  the  fact  that  lean  flesh  foods  are 
composed  almost  wholly  of  protein  —  and  an  excess  of  pro- 
tein, both  animal  and  vegetable,  is  almost  universally  regarded 
as  one  of  the  causes  of  this  alarming  increase  in  kidney,  liver, 
heart,  and  vascular  disorders  which  we  have  under  considera- 
tion. 

Protein  represents  a  food  substance  very  essential  to  life 
and  health,  but  also  very  deleterious  to  our  well-being  when 
eaten  in  excess.  It  is  not  so  freely  and  completely  oxidized  or 
burned  up  in  the  body  as  are  such  food  elements  as  fats, 
starches,  and  sugars.  When  protein  is  burned  up  in  the  body 
it  leaves  behind  a  group  of  cinders  which  work  the  mischief 
with  the  liver  and  kidneys  when  one  overeats  of  these  foods 
which  are  so  largely  protein  in  composition.  The  highly  pro- 
tein foods  are :  lean  meats  —  including  fish  and  fowl  —  whites 
of  eggs,  cheese,  the  casein  of  milk,  the  gluten  of  breads  and 
cereals,  most  nuts,  together  with  dried  peas,  beans,  and  lentils. 
These  foods  are  all  good  —  they  cause  trouble  only  when 
we  eat  too  much  or  too  many  of  them  in  one  day  or  at  the 
same  meal. 

Auto-intoxication  is  probably  one  of  the  most  common 
causes  of  high  blood-pressure  and  the  resultant  increase  in 
degenerative  diseases.  When  an  excess  of  food  is  taken 
into  the  digestive  tract,  the  machinery  of  digestion  is  clogged ; 
fermentation  and  putrefaction  are  favored,  especially  if  this 
excess  is  largely  protein ;  and  as  a  result,  there  are  generated 
poisons  which  raise  the  blood-pressure  and  irritate  the  kid- 
neys. Nervous  depression  may  also  predispose  to  sluggish- 
ness of  the  bowels. 

Auto-intoxication  means  self-poisoning,  and  refers  to  spe- 


CAUSES  OF  "OLD-AGE"  DISORDERS  159 

cial  poisons,  which  may  be  produced  in  the  body,  due  to  de- 
rangement of  digestion  and  metabolism,  as  in  the  case  of  in- 
testinal putrefaction.  The  colon  of  man  is  inhabited  by  un- 
told billions  of  germs  (colon  bacilli),  and  these  secrete  a  toxin 
or  poison,  which  often  has  a  tendency  to  raise  blood-pressure. 
The  same  is  true  of  the  toxins  of  many  other  disease  germs. 

Chronic  constipation  indirectly  favors  a  rise  in  blood- 
pressure,  in  the  case  of  some  persons,  by  allowing  large  quan- 
tities of  matter  to  accumulate  in  the  bowel,  thus  favoring  pu- 
trefaction and  the  retention  and  subsequent  absorption  of 
the  poisons  commonly  originating  in  this  part  of  the  diges- 
tive tract. 

If  you  have  high  blood-pressure  or  are  in  any  manner 
threatened  with  kidney  or  heart  disorders,  you  should  make 
it  a  business  to  have  at  least  two  free  bowel  movements 
every  twenty-four  hours.  Train  yourself  to  go  to  stool 
each  morning  and  evening.  This  is  one  of  the  most  impor- 
tant of  all  the  instructions  which  this  chapter  may  contain. 

4.  Deficient  elimination. —  Too  little  physical  exercise,  fail- 
ure to  get  eight  glasses  of  liquid  into  the  system  every 
twenty-four  hours;  too  little  sweating  —  too  much  of  a  sed- 
entary life  —  accompanied  by  chronic  constipation  and  its 
resultant  auto-intoxication,  are  all  causes  of  premature  old 
age.  On  the  other  hand,  exposure  and  long-continued  over- 
work may  contribute  to  arterial  degeneration. 

By  long-continued  exposure  of  the  skin,  the  blood  is  driven 
from  the  cutaneous  vessels  (as  evidenced  by  the  pallor  and 
goose-flesh  appearance).  This  forcing  of  the  blood  upon 
the  internal  organs  greatly  raises  the  blood-pressure  and 
produces  injurious  congestion  of  these  involved  structures 
and  organs. 

Moderate,  daily,  and  well-balanced  exercise  in  the  open 
air  is  invaluable  in  the  prevention  and  treatment  of  this 
whole  group  of  disorders. 


160  RACE  DECADENCE 

5.  Chrome  infections. —  Frequent  colds,  chronic  colds  in 
the  head  (sinus  infection),  pyorrhea,  ulcerated  teeth  (almost 
one-half  of  old  crowns  and  bridges  are  found  infected  on 
X-ray  examination),  bad  tonsils,  adenoids,  chronic  appendi- 
citis, inflammation  of  the  gall  bladder  and  gall  stones,  ulcers 
of  the  stomach  and  duodenum;  and  in  the  case  of  women, 
chronic  infection  in  some  of  the  pelvic  organs  —  in  fact  any 
place  in  the  human  body  where  microbes  are  able  to  main- 
tain a  latent  existence  and  send  forth  their  toxins  to  produce, 
first,  rheumatism,  neuralgia,  neuritis,  sciatica,  valvular  heart 
disease,  and  then,  subsequently,  arteriosclerosis  and  Bright's 
disease,  may  prove  to  be  causes  of  "  old-age "  disorders. 
These  pus  reservoirs  have  lately  come  to  be  known  as  "  focal 
infections." 

You  cannot  harbor  pus  in  any  part  of  the  body  over  a  long 
period  of  years  without  suffering  more  or  less  serious  con- 
sequences. The  toxins  of  these  pus  microbes  are  —  many 
of  them  at  least  —  highly  irritating  to  the  delicate  mem- 
branes which  line  the  heart,  liver,  kidneys,  and  blood  vessels, 
and  the  result  of  their  long-continued  action  is  to  set  up  a 
degenerative  reaction  which  in  and  of  itself  constitutes  this 
group  of  "  old-age  "  disorders. 

6.  The  mental  attitude. —  A  mental  state  of  chronic  fear, 
worry,  and  definite  dread,  together  with  mental  unrest,  anx- 
iety, fits  of  bad  temper,  etc.,  all  contribute  to  a  temporary  or 
permanent  rise  in  blood-pressure,  and  medical  authorities  are 
now  inclined  to  think  that  not  only  does  this  hardening  of 
the  arteries  raise  the  blood-pressure,  but  that  the  raising  of 
the  blood-pressure  by  mental  or  emotional  means,  in  time  may 
contribute  something  to  the  hardening  of  the  arteries.     In 
many  cases,  a  fairly  high  blood-pressure  is  found  to  be  al- 
most entirely  due  to  a  nervous  or  emotional  state. 

Fear  is  a  definite  cause  of  disease.  Worry  is  a  foe  to 
health.  Anxiety  is  a  mental  poison  that  in  many  respects 


CA  USES  OF  "  OLD- A  GE  "  DISORDERS  1 6 1 

exerts  the  same  deleterious  effect  on  the  body  as  literal 
poisons  introduced  from  without.  Those  who  would  avoid 
high  blood-pressure  must  avoid  worry  and  anxious  care. 

Disappointment,  cankering  care  and  corroding  grief,  all 
act  their  part  in  producing  that  condition  of  the  nervous 
system  which  results  in  raising  the  blood-pressure.  It  is  a 
well-known  fact  that  victims  of  high  blood-pressure  often 
burst  a  blood  vessel  during  a  fit  of  anger.  Numbers  of  people 
have  met  death  in  this  way.  This  is  due  to  the  fact  that 
anger  and  other  intensd  emotions  have  power,  through  the 
nervous  system,  quickly  to  raise  the  blood-pressure.  Eye- 
strain  is  also  a  common  cause  of  high  blood-pressure. 

Undue  excitement  directly  raises  the  blood-pressure  and  is 
probably  one  of  the  most  common  causes  of  high  blood- 
pressure,  outside  of  dietetic  habits.  Modern  society  exists  in 
a  state  of  more  or  less  constant  tension.  Almost  every  form 
of  modern  amusement  is  constructed  with  a  view  to  thrilling, 
startling,  and  exciting  the  spectator ;  and  all  this  reacts  upon 
the  nervous  system  in  disturbing  the  blood-pressure.  The 
inordinate  craving  to  be  hurled  through  space  at  increasingly 
perilous  speed  is  likewise  both  a  cause  and  a  result  of  the 
modern  high-pressure  regime. 

Gambling  and  other  games  of  chance  also  play  their  part. 
These  various  engagements  of  chance  all  interfere  with  the 
blood-pressure  by  means  of  worry,  excitement,  and  some- 
times the  crushing  disappointment  and  bitter  remorse  that 
must  inevitably  follow  in  the  defeat  that  comes  to  all  who  risk 
their  substance  on  the  wheel  of  fortune. 

The  strenuous  life  is  that  combination  of  modern  methods 
of  living  which  is  the  typical  regime  of  modern  money- 
makers, and  the  strenuous  life  usually  raises  the  blood-pres- 
sure. 

Among  the  moral  causes  of  high  blood-pressure  should  be 
mentioned  an  accusing  conscience  —  moral  condemnation. 


1 62  RACE  DECADENCE 

This  condition,  in  which  one  has  lost  peace  of  mind,  indi- 
rectly contributes  to  a  rise  in  blood-pressure.  The  one  who 
is  not  at  peace  with  God  and  man  cannot  so  easily  maintain 
that  state  of  mind  and  thought  requisite  to  normal  blood- 
pressure.  Condemnation  of  conscience  brings  in  its  wake 
all  those  high-pressure-breeding  influences  of  worry,  anxiety, 
sorrow,  remorse,  etc. 

7.  Heredity. —  Again  attention  must  be  called  to  the  fact 
that  certain  families  tend  to  grow  old  early.  They  are,  by 
inheritance,  constitutionally  inferior  to  their  fellows.  They 
possess  a  low  degree  of  resistance  to  disease  in  general  and 
thus,  through  hereditary  predisposition,  they  more  readily 
succumb  to  all  of  the  influences  and  agencies  which  conspire 
to  bring  on  premature  old  age. 

While  the  individual's  personal  habits  of  living,  and  the 
microbic  diseases  to  which  he  may  —  accidentally  or  inci- 
dentally—  have  been  subjected,  all  have  a  great  influence  in 
the  premature  production  of  "  old-age  "  disorders,  neverthe- 
less, the  fact  remains,  that  certain  individuals  and  families 
possess  this  inherent  tendency  or  weakness  to  grow  old  pre- 
maturely. So  it  would  appear,  in  our  efforts  to  lengthen  life 
and  to  combat  "  old-age  "  disorders,  that  we  must  indirectly 
reckon  with  the  fact  that  inherited  vitality  is  a  factor  which 
must  be  recognized.  And  the  statistics  we  are  compiling, 
which  show  such  a  startling  increase  in  "  old-age  "  disorders 
and  in  the  death-rate  from  these  degenerative  diseases,  sug- 
gest the  fact  that  our  degenerative  and  defective  stocks  are 
possibly  increasing  much  faster  than  our  more  substantial, 
wholesome,  and  long-lived  strains.  In  other  words,  the 
startling  increase  in  the  death-rate  from  "  old-age  "  disorders, 
in  recent  decades,  may  not  be  entirely  due  to  bad  methods  of 
living  —  deleterious  hygienic  practices  —  but  may  also  be  due 
to  the  fact  that  we  are  having  born,  in  each  generation,  a 
greater  number  of  persons  belonging  to  those  defective  human 


CAUSES  OF  "OLD-AGE"  DISORDERS  163 

strains  which  are,  by  inheritance,  predisposed  early  to  suc- 
cumb to  these  degenerative  diseases. 

This,  then,  is  the  story  of  the  chief  causes  of  the  degener- 
ative diseases  and  constitutes  the  explanation  of  their  great 
increase  in  modern  times.  Let  us  now  turn  our  attention  ta 
some  of  the  remedies  for  this  recent  increase  in  heart  and 
kidney  troubles. 

SUMMARY  OF  THE  CHAPTER 

1.  Among  the  chief  causes  of  premature  "old-age"  dis- 
orders are  such  drugs  as  alcohol,  tobacco,  patent  medicines, 
headache  powders,  and  the  excessive  use  of  tea  and  coffee. 

2.  A  single  cigar  will  raise  the  blood-pressure  for  an  hour 
or  more  in  many  individuals. 

3.  Tobacco  has  a  further  influence  on  the  digestive  organs 
and  the  nervous  system  in  addition  to  its  effect  on  blood- 
pr^ssure. 

4.  The  cigars  used  each  year  in  this  country,  laid  end  to 
end,  would  reach  halfway  to  the  moon. 

5.  The  American  people  spend  more  money  each  year  for 
tobacco  than  for  bread. 

6.  Last  year  we  smoked  over  46,000,000,000  manufactured 
cigarettes  —  to  say  nothing  of  the  home-made  article. 

7.  During  the  last  ten  years  there  has  been  an  increase 
of  40,000,000,000  cigarettes.    Laid  end  to  end,  the  cigarettes 
used  each  year  would  reach  around  the  world  thirty  times. 

8.  For  every  person  in  the  United  States  there  is  consumed 
each  day  356  grains  of  alcohol,  6  grains  of  nicotine,  6  grains 
of  caffeine,  1.5  grains  of  opium.  A  total  of  nearly  364  grains 
of  narcotics. 

9.  There  was  used  in  this  country  1,227,736,620  pounds  of 
tea  and  coffee  last  year;  twelve  pounds   for  every  man, 
woman  and  child.    The  United  States  coffee  bill  is  $150,000,- 
ooo  a  year. 

10.  The  poisons  of  syphilis,  together  with  chronic  lead 
poisoning,  are  among  the  prominent  causes  of  premature 
"  old-age  "  diseases. 

11.  Habitual  overeating  —  three   square  meals  a  day  — 


1 64  RACE  DECADENCE 

together  with  overseasoning  of  foods,  lies  at  the  bottom  of 
many  early  deaths  from  high-pressure  disorders. 

12.  We  eat  too  many  condiments.    Beware  of  foods  that 
are  "  hot  "  when  they  are  cold. 

13.  Americans  eat  too  much  meat  and  too  little  fruit.  Many 
have  the  "  salt  habit  "  —  so  harmful  to  the  kidneys. 

14.  Excess  of  protein  (meat)  works  a  particular  hardship 
on  the  liver  and  kidneys  and  tends  to  raise  blood-pressure. 

15.  Auto-intoxication  is  among  the  common  causes  of  high 
blood-pressure;  and  is  in  turn  so  often  due  to  chronic  con- 
stipation. 

1 6.  In  case  of  deficient  elimination  and  high  blood-pres- 
sure, drink  plenty  of  water,  sweat  often,  and  secure  two  bowel 
movements  each  day. 

17.  Moderate,  well-balanced  exercise  in  the  open  air  is  in- 
valuable in  the  management  of  these  "  habit  disorders." 

1 8.  Premature  "  old-age  "    diseases    and    death  are  also 
caused  by  the  poisons  (toxins)  of  such  chronic  infections  as 
colds  in  the  head,  pyorrhea,  ulcerated  teeth,  diseased  tonsils, 
chronic  appendicitis,  gall-bladder  disease,  etc. 

19.  All  pus  reservoirs  (focal  infections)  cause  first,  rheu- 
matism and  neuritis,  then  heart  disease,  hardening  of  the  ar- 
teries, Bright's  disease,  etc. 

20.  Chronic  worry  and  anxiety  cause  high  blood-pressure 
and  premature  old  age.    Fear  is  a  definite  cause  of  disease. 

21.  Excitement,  anger,  and  "  cankering  care  "  all  contribute 
to  high  blood-pressure  and  premature  old  age. 

22.  An  accusing  conscience  also  adds  to  the  sum  of  all 
those  influences  which  may  so  affect  the  nervous  system  as  to 
raise  blood-pressure  and  contribute  to  early  decay. 

23.  Some  individuals  are  predisposed  to  early  affliction  of 
degenerative  diseases  by  heredity. 


CHAPTER  XII 
TREATMENT  OF  "  OLD-AGE  "  DISORDERS 

HAVING  carefully  considered  the  causes  of  "  old-age  " 
disorders  in  the  preceding  chapter,  it  will  now  be  in 
order  to  discuss  the  remedies.  Of  course,  the  first  of  all 
remedies  for  any  human  disease  is  prevention  —  and  the  next 
most  important  thing  is  the  removal  of  all  exciting  and  pre- 
disposing causes  which  may  be  operating  to  produce  the  dis- 
order we  wish  to  combat. 

What,  then,  is  to  be  done  about  this  alarming  increase  in- 
degenerative  diseases?  There  are  just  four  answers  to  this 
great  question : 

1.  Reformation  in  habits  of  personal  living,  in  our  methods 
of  eating,  drinking,  sleeping,  working,  etc.    Attention  must 
be  given  to  both  the  hygienic  and  industrial  sides. 

2.  Chronic  or  focal  infections  must  be  prevented.    Teeth, 
tonsils,  and  internal  organs  must  not  be  allowed  to  assume 
the  role  of  little  toxin  foxes  which  are  able  so  effectually  to 
undermine  the  constitutional  health. 

3.  Thoroughgoing,  exhaustive,  and  periodical  research  ex- 
aminations, or  "  health  audits  "  must  become  part  of  our  na- 
tional life  in  order  to  detect  the  early  beginnings  of  these 
"  old-age  "  disorders. 

4.  We  must  give  proper  consideration  to  the  eugenic  as- 
pects of  the  question. 

REMEDIES 

In  the  early  stages  of  degenerative  disorders  it  comes  to 
be  —  as  regards  treatment  —  largely  a  question  of  the  man- 

165 


166  RACE  DECADENCE 

agement  of  high  blood-pressure.  A  high  pressure  accompa- 
nies and  is  indicative  of  most  of  these  troublesome  ailments. 
In  fact,  it  long  precedes  many  of  these  kidney  disorders  of 
the  more  serious  sort.  In  the  case  of  a  failing  heart,  the 
blood-pressure  may  fall  —  though  it  was  undoubtedly  above 
normal  at  some  time  previous. 

The  most  helpful  methods  of  combating  high  blood-pres- 
sure in  particular  and  the  accompanying  "  old-age  "  disorders 
in  general,  may  be  summarized  as  follows : 

/.  Exercise. —  Active  physical  exercise,  to  the  point  of 
gentle  perspiration,  brings  a  large  amount  of  blood  to  the 
muscles.  It  dilates  the  vessels  of  the  skin,  producing  a 
ruddy  glow,  the  same  as  does  the  use  of  alcohol,  only  this 
dilation  is  even  more  permanent  and  is  not  followed  by  an 
undesirable  reaction.  Walking,  riding,  rowing,  running, 
swimming,  gymnasium  work,  and  all  forms  of  exercise,  pref- 
erably those  in  the  open  air,  with  the  clothing  loose  and  free, 
are  all  most  powerful  agents  in  lowering  blood-pressure,  and 
should  be  intelligently  and  systematically  utilized  by  all  mod- 
erately high-pressure  victims.  (See  Fig.  n.)  Passive  ex- 
ercise always  lowers  the  blood-pressure  and  from  the  very 
beginning.  If  you  have  high  pressure  consult  with  your  phy- 
sician regarding  the  proper  exercise  for  your  case. 

//.  Massage  and  skin  friction. —  In  the  case  of  feeble  pa- 
tients —  bedridden  patients  who  cannot  stand  vigorous  exer- 
cise, and  those  who  have  weak  hearts  or  hardened  arteries 
(which  condition  makes  it  unsafe  for  them  to  take  the  more 
vigorous  exercises  and  baths)  —  massage  and  skin  friction 
are  useful. 

The  cold-mitten  friction,  in  which  a  rough  mohair  mitt  or 
Turkish  cloth  is  dipped  in  ice  water  and  rubbed  over  one  part 
of  the  body  at  a  time,  is  excellent  for  these  cases.  Dry  fric- 
tion is  also  useful. 

Deep  massage  of  the  muscles  enormously  increases  the 


Fig.  11.    Exercises  adapted  to  moderately  high  blood-pressure 


TREA TMENT  OF  "  OLD-AGE  "  DISORDERS  167 

amount  of  blood  circulating  through  them,  and  in  this  way 
relieves  the  general  arterial  tension. 

///.  The  neutral  or  tepid  bath. —  This  bath  lowers  the 
blood-pressure  by  dilating  the  vessels  of  the  skin  and  quieting 
the  heart.  Try  it  sometime  when  you  are  restless,  nervous, 
fretful,  can't  sleep,  head  throbbing  —  take  a  neutral  bath, 
from  97°  to  100°  F.  Stay  in  the  bathtub  anywhere  from 
fifteen  to  forty-five  minutes.  Oxygen  baths  are  also  very 
beneficial  in  many  cases  of  high  pressure. 

IV.  The  cold  bath. —  The  cold  bath,  likewise,  by  the  vig- 
orous reaction  that  follows  it,  lowers  the  blood-pressure. 
Warm  baths  must  be  continued  for  a  number  of  minutes  in 
order  to  lower  the  blood-pressure,  and  the  neutral  bath  from 
fifteen  to  about  thirty  minutes,  but  cold  baths  must  be  short, 
in  order  to  lower  the  blood-pressure.    The  salt  bath  or  salt 
glow  is  doubly  useful. 

V.  The  sun  bath. —  The  sun  bath  is  of  great  value  in  re- 
lieving high  pressure,  if  properly  taken,  as  it  not  only  diverts 
blood  to  the  skin,  but  the  "  sunburn  "  is  a  sort  of  physiolog- 
ical inflammation  that  causes  the  blood  to  circulate  freely  in 
the  skin  for  days  following  exposure  to  the  sun's  rays.  Keep 
the  head  cool  —  protected  from  the  sun.     Keeping  the  skin 
warm  always  helps  in  lowering  blood-pressure.    Always  keep 
the  feet  warm  —  summer  and  winter. 

VI.  Sleep  and  rest  —  by  their  every  influence,  directly 
and  indirectly,  tend  to  lower  the  blood-pressure.     It  is  very 
apparent  that  a  kind  Providence  has  provided  the  suffering 
race  with  many  useful  and  inexpensive  means  for  lowering 
the  blood-pressure.    Why  should  we  resort  to  the  unnatural 
agencies  of  harmful,  habit-producing  drugs  in  order  to  re- 
lieve the  high-pressure  tension  and  the  nervous  restlessness 
of  the  age?    Let  us  reform  the  diet,  set  the  mind  at  rest, 
eliminate  all  high-pressure  causes,  get  the  sweet  peace  that 
comes  from  religious  consolation ;  and  then,  in  times  of  tem- 


1 68  RACE  DECADENCE 

porary  high  pressure  and  unpleasant  tension,  resort  to  the 
simple  baths,  exercise,  sun  baths,  massage,  etc.,  for  relief. 

VII.  Mental  factors  —  in  lowering  pressure  are  cheerful- 
ness and  contentment.    We  need  not  repeat  here  what  al- 
ready has  been  stated  concerning  the  health-producing  possi- 
bilities of  happiness.    Mental  cheerfulness  is  essential  to  good 
digestion.    It  promotes  the  circulation  of  the  blood  by  its  in- 
fluence over  the  vasomotor  nerves,  and  thus  indirectly  influ- 
ences the  blood-pressure.    Mental  peace  is  a  powerful  anti- 
high-pressure  influence. 

Self-control  has  been  defined  as  temperance,  and  temper- 
ance is  the  keynote  of  success  in  controlling  blood-pressure. 
Regular  and  even  habits  of  life  favor  normal  pressure.  "A 
conscience  void  of  offense  toward  God  and  man,"  by  its  be- 
neficent influence  upon  the  mind  —  effectually  eliminating  all 
grounds  for  worry,  remorse,  and  anxiety  —  tends  to  promote 
and  maintain  a  normal  blood-pressure. 

Moral  faith  and  spiritual  trust  are  the  climax  of  power  in 
the  psychic  battle  against  the  high-pressure  life.  Faith  and 
trust  are  the  guardian  angels  of  the  simple  life;  they  are  the 
ancestors  of  every  mental  trait  of  happiness  and  self-control, 
all  of  which  are  valuable  in  preventing  increased  blood- 
pressure. 

VIII.  Dietetic  simplicity. —  Discard  fiery  spices  and  condi- 
ments.   In  the  battle  against  high  blood-pressure  and  degen- 
erative diseases  it  is  necessary  that  all  irritating  condiments 
and  spices  should  be  cast  out  of  the  dietary.     Vinegar  has 
been  found  to  be  almost  as  powerful  in  producing  hardening 
of  the  arteries  in  the  liver  of  a  guinea-pig  as  alcohol. 

Vegetables,  grains,  fruits,  and  nuts  do  not  contain  sub- 
stances which  excite  high  pressure  unless  such  foods  as  nuts 
and  legumes  are  taken  in  too  large  quantites.  The  less  meat 
eaten  the  better  for  the  victim  of  high  blood-pressure. 

Good,  normal  digestion,  in  which  food  is  not  allowed  to 


TREA  TMENT  OF  "  OLD -A  GE  "  DISORDERS         1 69 

remain  too  long  in  any  one  part  of  the  digestive  tract,  con- 
tributes to  keeping  the  blood-pressure  normal  by  preventing 
the  generation  of  high-pressure  toxins  as  a  result  of  indiges- 
tion. 

Regular  bowel  movements  (at  least  twice  a  day)  prevent 
the  absorption  of  intestinal  toxins,  which  have  a  tendency  to 
raise  blood-pressure. 

While  there  is  a  great  difference  of  opinion  regarding  the 
value  of  dieting  in  these  cases  of  Bright's  disease  and  high 
blood-pressure  we  believe  that  a  proper  regulation  of  the 
diet  is  highly  important  and,  in  most  cases,  very  helpful  in 
the  treatment  of  this  class  of  patients. 

We  are  in  the  habit  of  giving  our  patients  with  kidney 
disorders  the  following  general  dietetic  instructions : 

SPECIAL  DIET  LIST  FOR  KIDNEY  DISORDERS 

(LOW  PROTEIN  AND   SALT-FREE  DIETS ) 

This  diet  is  indicated  in  all  forms  of  kidney  disorder  — 
Bright's  disease,  acute  nephritis,  chronic  interstitial  nephritis, 
arteriosclerosis,  high  blood-pressure,  heart  disease,  etc.  This 
low  protein  diet  is  also  valuable  in  nervous  sick  headache 
(migraine),  acidemia,  rheumatism,  neuralgia,  neuritis,  and 
auto-intoxication. 

/.  Fruits:  Ripe  olives,  grapefruit,  lemons,  oranges,  cran- 
berries, strawberries,  blackberries,  raspberries,  gooseberries, 
blueberries,  huckleberries,  pineapples,  watermelons,  peaches, 
apples,  pears,  apricots,  cherries,  currants,  plums,  prunes,  ba- 
nanas, grapes,  cantaloupes,  dates,  figs,  raisins,  dried  fruits, 
and  fruit  juices. 

2.  Vegetables:  Lettuce,  cucumbers,  spinach,  asparagus, 
rhubarb,  sorrel,  greens,  cabbage,  sauerkraut,  celery,  tomatoes, 
Brussels  sprouts,  water  cress,  okra,  cauliflower,  eggplant, 


170  RACE  DECADENCE 

radishes,  string  beans,  turnips,  beets,  carrots,  onions,  squash, 
pumpkin,  mushrooms,  artichokes,  parsnips,  green  peas,  pota- 
toes, sweet  potatoes,  green  corn,  oyster  plant,  and  vegetable 
soups. 

j.  Nuts:    Chestnuts,  cocoanuts,  and  pecans. 

4.  Dairy  products:     Butter,  milk,  cream,  buttermilk,  and 
yolks  of  eggs. 

5.  Cereals:     Arrowroot,  breads   (limited  amount),  corn- 
starch,  cornmeal  products,  corn  flakes,  macaroni,  oatmeal, 
rice,  sago,  tapioca,  and  Zwieback.     Bread  should  be  eaten 
sparingly. 

6.  Meats:     Bacon  and  oysters,  other  meats  only  in  ac- 
cordance   with    physician's    orders.     The    legumes  —  dried 
peas,  beans,  lentils,  and  peanuts  are  to  be  regarded  the  same 
as  meat  —  i.  e.,  eaten  only  as  ordered. 

7.  Special  foods  to  avoid:    Lean  meats,  fish,  poultry,  meat 
broths,  all  rich,  highly  seasoned  food,  such  as  gravies,  dress- 
ings, pastries,  etc.,  including  common  salt  and  condiments, 
tea,  coffee,  shell  fish,  cheese,  and  whites  of  eggs.    Avoid  all 
foods  containing  much  salt. 

8.  Salt-free  diet:     In  acute  or  severe  kidney  trouble,  a 
salt-free  diet  (or  nearly  so)  can  be  had  by  subsisting  on  the 
following : 

a.  Cereals  —  cooked  without  salt. 

b.  Fresh  fruits  —  raw,  or  cooked  without  salt. 

c.  Fresh  vegetables  —  raw,  or  cooked  without  salt. 

d.  Eggs  —  raw,  or  cooked  without  salt. 

e.  Milk,  cream,  buttermilk,  and  butter  made  without 
salt. 

p.  Milk  diet:  When  milk  diet  is  ordered  for  Bright's  dis- 
ease, it  is  given  by  special  instructions,  in  accordance  with 
the  general  regime  as  outlined  in  connection  with  the  "  Spe- 
cial Milk  Diet."  (See  Appendix  C.) 


TREATMENT  OF  "OLD-AGE"  DISORDERS         I?I 

JO.  Water  drinking:  The  amount  of  water  which  should 
be  taken  each  day  depends  on  the  stage  of  the  kidney  dis- 
order, the  amount  of  urine  passed,  sweating,  the  presence 
of  edema,  dropsy,  etc.,  and  should  be  prescribed  for  each  in- 
dividual case.  Carbonated  waters  are  good,  but  most  mineral 
waters  are  of  little  or  no  value,  aside  from  their  laxative 
properties. 

11.  Drugs:    In  following  a  diet  for  kidney  disorders,  re- 
frain from  taking  any  drugs  or  medicines  not  prescribed  by 
your  doctor.     Avoid  the  use  of  all  forms  of  alcohol  and 
tobacco. 

12.  Acid  and  alkaline  foods:     It  is  desirable  to  combat 
acidity  of  the  blood-stream  in  B  right's  diesase,  and  as  an  aid 
in  this  direction  alkalies  are  sometimes  prescribed  for  tem- 
porary benefit;  but  the  best  method  of  attaining  this  end  is 
to  eat  more  largely  of  the  "  alkaline  "  than  of  the  "  acid  " 
fodds —  see  following  list  of  "Acid  and  Alkaline  Foods." 

With  the  possible  exception  of  fats  and  sugars,  practically 
every  article  of  one's  diet  contributes  either  directly  or,  in- 
directly to  acidifying  or  alkalinizing  the  blood.  In  order  to 
enable  the  patient  more  fully  to  understand  this  important 
principle  of  scientific  dietetics,  we  have  arranged  the  follow- 
ing table  of  parallel  comparisons,  which  will  show  at  a  glance 
what  will  be  the  final  digestive  outcome  of  the  various 
foods  —  as  regards  the  acidity  and  alkalinity  of  the  blood- 
stream. 

Space  will  not  permit  the  listing  of  a  great  number  of  in- 
dividual foods,  but  the  general  classes  noted  will  enable  the 
patient  easily  to  ascertain  to  what  group  any  commonly  used 
food  belongs,  and  so  be  able  to  arrange  his  diet  accordingly. 

List  of  foods  showing  the  end-products  of  digestion  in- 
creasing or  decreasing  the  acidity  and  alkalinity  of  the  blood. 
(Fats  and  sugars  are  practically  negative  and  are  therefore 
not  included  in  this  classification.) 


172  RACE  DECADENCE 

• 

FOODS  WHICH  TEND  TO  ACIDIFY  THE  BLOOD 

1.  Animal  foods:    All  forms  of  flesh  foods,  fish,  fowl, 
etc.,  including  all  kinds  of  meat  broths,  soups,  beef  tea, 
bouillon,  etc. 

2.  Eggs. 

3.  Breadstuffs:    All  kinds  of  breads,  whether  made  of 
wheat,  rye,  or  corn,  crackers,  toasts,  griddle  cakes,  etc. 

4.  Pastries:    All  sorts  of  pies  and  cakes  (except  fruit 
pies,  and  other  desserts  containing  milk  or  sour  fruits). 

5.  Cereals:     Rice,  oatmeal,  and  breakfast  foods  of  all 
kinds,  including  the  flaked  and  toasted  breakfast  foods. 

6.  Miscellaneous:     Peanuts,   plums,   prunes,   and   cran- 
berries.    (Plums  and  cranberries  come  under  this  head- 
ing because  of  their  benzoic  acid,  which  the  body  cannot 
fully  oxidize.) 

FOODS  WHICH  TEND  TO  ALKALINIZE  THE  BLOOD 

1.  Dairy   products:     Milk,    ice   cream,   cottage   cheese, 
cheese,  buttermilk,  etc. 

2.  Soups:    All  forms  of  vegetable  and  fruit  soups  and 
broths. 

3.  Fruit  juices:     All   the   fresh   fruit   juices    (except 
plums). 

4.  Fresh  fruits :    All  fresh  fruits  —  sweet  and  sour  — 
(except  plums  and  cranberries). 

5.  Dried   fruits:     All   dried    fruits    (except   prunes)  — 
especially  figs,  raisins,  dates,  and  currants. 

6.  Vegetables:     All  kinds  —  especially  beets,  carrots, 
celery,  and  lettuce. 

7.  The  legumes:     Beans,  peas,  and  lentils. 

8.  Nuts:     All  the  nuts  come  under  this  heading,  in- 
cluding almonds  and  chestnuts. 

9.  Miscellaneous:     Potatoes  and  bananas. 


TREATMENT  OF  "OLD-AGE"  DISORDERS         173 

For  special  diets  adapted  to  combating  auto-intoxication 
and  chronic  constipation,  the  reader  is  referred  to  Appen- 
dix C. 

The  milk  diet:  In  other  cases  of  high  blood-pressure  and 
associated  kidney  disorders,  it  is  best  to  put  the  patient  to  bed 
on  a  diet  of  milk  alone  —  or  milk  in  combination  with  fruit 
juices.  From  two  to  six  weeks  of  this  "  rest  cure  "  is  often 
of  great  value.  For  details  of  the  milk  diet  see  Appendix  C. 

IX.  Disease  toxins. —  If  you  have  syphilis  —  treat  it  — 
and  treat  it  thoroughly  and  scientifically.  When  you  think 
you  are  cured,  follow  up  the  matter  with  Wassermann  tests 
once  or  twice  a  year  for  at  least  five  years.  Take  no  chances 
•with  this  —  the  most  frequent  single  cause  of  the  degenera- 
tive diseases. 

X-ray  your  teeth  —  all  of  them  —  at  least  all  dead  teeth. 
X-ray  your  gall  bladder  if  you  suspect  it,  or  if  you  have  ever 
had' typhoid  fever. 

Don't  go  through  life  with  chronic  sore  throat,  colds  in 
the  head,  chronic  appendicitis  —  or  any  other  chronic  infec- 
tion which  harbors  pus  germs  at  any  place  in  the  body.  If 
in  doubt  —  go  to  the  bottom  of  your  complaint  —  get  at  the 
facts  and  then  act.  Employ  the  best  dentists  and  the  most  up- 
to-date  doctors  at  your  disposal  and  wipe  out  these  "  little 
foxes  "  which  are  at  the  bottom  of  so  much  of  our  present- 
day  premature  old  age. 

HIGH    AND   LOW    BLOOD-PRESSURE 

In  order  that  the  reader  may  become  familiar  with  the  sub- 
ject of  blood-pressure  the  following  hints  regarding  both  high 
and  low  pressure  are  given: 

i.  Normal  blood-pressure. —  The  normal  blood-pressure 
for  men  at  20  years  is  120  mm.  of  mercury.  The  normal 
pressure  for  women  at  20  years  is  about  1 10  mm.  The  low- 
est normal  limits  are  95  for  women  and  105  for  men. 


174  RACE  DECADENCE 

2.  Normal  range  of  pressure. —  There  is  a  normal  varia- 
tion in  blood-pressure  of  about  30  points  (mm.)  that  is,  the 
pressure  may  run  15  points  above  or  15  points  below  the 
average  normal  for  any  given  age  without  being  considered 
abnormal.  Therefore,  at  20  years  of  age  a  man's  pressure 
might  range  from  105  up  to  135  without  suggesting  disease, 
while  a  woman's  pressure,  at  the  same  age,  might  run  from 
95  to  125  mm.  The  author  believes  that  "  average  "  pressure 
is  a  trifle  higher  than  "  normal  "  pressure. 

5.  Blood-pressure  in  relation  to  age. —  The  blood-pressure 
rises  i  mm.  (i  point)  for  every  2  years'  increase  in  age. 
Women  at  any  given  age  exhibit  a  pressure  about  10  points 
below  that  of  men  of  the  same  age.  High  pressure  becomes 
dangerous  when  it  reaches  185  or  190.  Blood-pressure  usu- 
ally falls  a  trifle  after  90  years  of  age.  It  should  be  remem- 
bered that  one-third  of  all  cases  of  arteriosclerosis  exhibit  a 
normal  blood-pressure. 

4.  Normal  diastolic  pressure. —  In  many  respects  the  dias- 
tolic  pressure  is  of  more  importance  than  the  systolic.    The 
diastolic  pressure  should  normally  run  about  two-thirds  (70 
per  cent)  as  high  as  the  systolic.     (When  the  normal  in- 
dividual is  at  rest,  it  may  run  as  high  as  75  or  even  80  per 
cent  of  the  systolic  pressure.)   At  20  years  of  age  the  normal 
diastolic  pressure  runs  about  80  mm.  for  men  and  about  75 
mm.  for  women.    The  range  of  safety  for  the  diastolic  blood- 
pressure  —  for  both  men  and  women  —  runs  70  to  90  mm. 
A  diastolic  much  below  70  mm.  demands  attention;  while  a 
continued  diastolic  pressure  of  95  mm.  or  above  must  be 
regarded  seriously. 

5.  Normal  pulse  pressure. —  The  difference  between  the 
systolic,  or  heart-working  pressure,  and  the  diastolic,  or  heart- 
resting  pressure,  is  called  the  pulse  pressure  and  normally 
equals  about  one-third  or  30  per  cent  of  the  systolic  pressure. 
In  healthy  individuals  20  years  of  age  the  pulse  pressure  may 


TREATMENT  OF  " OLD-AGE "  DISORDERS         175 

vary  from  35  mm.  up  to  45  mm.     These  so-called  normal 
variations  are  increased  in  the  case  of  older  people. 

6.  The  mean  pressure. —  The  patient's  actual  mean  blood- 
pressure  is  by  no  means  always  the  exact  arithmetical  mean 
between  the  systolic  and  diastolic  pressure.    The  actual  mean 
pressure  usually  more  closely  follows  the  diastolic  pressure. 
As  a  general  rule  the  mean  pressure  can  be  quite  accurately 
estimated  by  adding  about  one-third  of  the  pulse  pressure  to 
the  diastolic  pressure.    The  normal  limits  of  mean  pressure 
at  20  years  of  age,  range  from  85  mm.  up  to  no  or  some- 
times even  115  mm. 

7.  Normal  variations. —  The  following  influences  and  con- 
ditions are  able  to  produce  variations  in  blood-pressure  which 
must  be  regarded  as  entirely  normal:  age,  sex,  size,  obesity, 
temperament,  time  of  day,  digestion,  muscularity,  exercise, 
fatigue,  posture,  rest,  sleep,  excitement,  nervousness,  fear, 
and  barometic  pressure. 

8.  Nervous   hypertension. —  The  high   pressure   of    fear, 
worry,  and  nervousness  can  sometimes  be  almost  instantly 
relieved  by  psychotherapy.    In  this  form  of  high  tension  the 
increased  pressure  is  chiefly  systolic,  as  the  mind  seems  to  be 
able  to  exert  little  or  no  influence  over  the  diastolic  pressure. 

The  mind  no  doubt  influences  blood-pressure  both  by 
direct  nervous  action  on  the  caliber  of  the  small  blood  ves- 
sels, and  by  indirect  chemical  action  by  means  of  its  in- 
fluence in  controlling  or  modifying  the  output  of  the  so- 
called  ductless  glands.  We  know  that  low  pressure  is  the 
usual  accompaniment  of  nervous  exhaustion,  although 
chronic  worry  or  melancholy  is  more  often  associated  with 
high  blood-pressure.  High  blood-pressure  is  almost  invari- 
ably associated  with  excitement  and  intense  anger. 

The  following  parallel  arrangement  of  high  and  low  blood- 
pressure  causes  serves  to  indicate  how  many  and  varied  are 
the  factors  which  may  influence  blood-pressure. 


176 


RACE  DECADENCE 


HIGH-PRESSURE   STATES      LOW-PRESSURE  STATES 


ARTERIOSCLEROSIS 

ANGINA  PECTORIS 

VAL.  HEART  DISEASE 

MYOCARDITIS 

APOPLEXY 

PARALYSIS 

BRIGHT'S  DISEASE 

ALCOHOL 

TOBACCO 

TEA  AND  COFFEE 

LEAD  POISONING 

OVEREATING 

OVERSEASONING 

MEAT  DIET 

CONSTIPATION 

AUTO-INTOXICATION 

TOXEMIAS 

MIGRAINE 

PREGNANCY 

UREMIA 

ACUTE  INFECTIONS 

HEAD   INFECTIONS 

THROAT  INFECTIONS 

GALL-BLADDER  INFECTIONS 

PELVIC  INFECTIONS 

CHRONIC  INFECTIONS 

SYPHILIS 

TABES  DORSALIS 

EXOPTH.  GOITER 

GLAUCOMA 

EMPHYSEMA 

EXPOSURE 

OVERWORK 

CHRONIC  PAIN 

Loss  OF  SLEEP 

STRENUOUS  LIVING 

WORRY  —  FEAR 

NERVOUSNESS 


WASTING  DISEASES 

ANEMIAS 

CHLOROSIS 

TUBERCULOSIS 

(early,  of  the  lung) 

THYROID  DISEASE 

ADDISON'S  DISEASE 

DIABETES 

PROSTATIC  DISEASE 

TYPHOID  FEVER 

ERUPTIVE  FEVERS 

PNEUMONIA 

(after  second  day) 

CHOLERA 

TOXEMIAS   (some) 

TOBACCO  HEART 

TOBACCO  (excessive) 

DELIRIUM   TREMENS 

ALCOHOL   (immediate) 

POOR  CIRCULATION 

CARDIAC  DILATATION 

CARDIAC  ASTHMA 

HEMORRHAGE 

SHOCK  —  COLLAPSE 

HEART  FAILURE 

CONSTIPATION 

(in   certain   cases) 

DIARRHEA 

JAUNDICE    (sometimes) 

PHOSPHATURIA 

NEURASTHENIA 

HYSTERIA   (sometimes) 

PARESIS 

EPILEPTIC  COMA,  NEURITIS,  SCI- 
ATICA, LUMBAGO,  ARTHRITIS 
and  MYALGIA  (when  the  acid- 
ity is  low) 


ANXIETY  —  ANGER 

Blood-pressure  is  not  a  constant  symptom.  Owing  to  varying 
nervous  and  chemical  states  of  the  body,  a  given  disease  may  pro- 
duce an  entirely  different  blood-pressure  reaction  in  different  in- 
dividuals. 


TREATMENT  OF  "OLD-AGE"  DISORDERS         177 

FALSE  AND  HARMFUL  METHODS  OF  LOWERING  BLOOD-PRESSURE 

Having  carefully  considered  the  causes  of  high  blood-pres- 
sure, together  with  natural  and  proper  methods  of  controlling 
and  lowering  pressure,  we  will  now  briefly  discuss  those  false 
and  dangerous  practices  and  habits  which  tend  to  lower  the 
pressure.  These  methods  are  transitory,  deceptive,  and  ex- 
ceedingly destructive;  they  represent  the  false  hope  of  ob- 
taining relief  from  the  tension  of  the  high-pressure  life. 

While  there  are  many  drugs  used  temporarily  by  physicians 
for  their  influence  in  lowering  blood-pressure,  we  will  con- 
sider here  only  those  which  are1  administered  by  thousands 
of  people  to  themselves. 

1.  Morphine  —  lowers  the  blood-pressure;  so,  when  the 
individual  has  used  cocaine,  which  results  in  unduly  raising 
the  pressure,  it  is  only  natural  that  he  should  seek  relief  from 
this  tension  by  the  use  of  either  alcohol  or  morphine.    This  is 
also  why  alcohol  and  tobacco  go  hand  in  hand,  tobacco  pro- 
ducing a  high  pressure,  alcohol  relieving  the  tension  by  tem- 
porarily producing  a  low  pressure ;  but  a  low  pressure  cannot 
be  long  tolerated  —  the  individual  must  have  something  to 
tone  him  up,  to  restore  the  pressure,  and  this  is  secured  by 
more  tobacco.     Likewise,  morphine  and  cocaine  play  into 
each  other's  hands  —  the  one  temporarily  counteracting  the 
effects  of  the  other,  until  the  unfortunate  victim  is  a  user 
of  both.    All  methods  of  relieving  high  pressure  by  drugs  are 
a  snare  and  a  delusion. 

2.  Alcohol  —  lowers    the    blood-pressure  —  for    the   time 
being.    Just  as  tobacco  produces  a  pale  skin  and  drives  the 
blood  inside,  thus  raising  the  pressure,  alcohol  produces  a 
red  flush  of  the  skin,  showing  that  the  blood  is  being  drawn 
to  the  skin,  and  the  blood-pressure  lowered.    This  is  why  one 
feels  warm  under  the  influence  of  alcohol,  even  when  he  is 
colder,  or  even  freezing. 


178  RACE  DECADENCE 

Now  we  begin  to  understand  the  vicious  circle  which  has 
been  perpetrated  on  the  human  race.  A  large  part  of  the 
people  use  tobacco.  They  are  all  living  the  strenuous  life. 
Their  dietetic  and  general  living  habits  are  those  belonging  to 
the  strenuous  order.  They  use  large  quantities  of  condi- 
ments, tea,  and  coffee.  But  this  cannot  be  kept  up  indefi- 
nitely. Several  times  a  day,  a  week,  or  a  month,  the  nervous 
individual  reaches  the  "  bursting  stage."  He  feels  wrought 
up  to  the  highest  pitch;  keyed  up  to  the  last  notch.  He  is 
intensified  to  the  highest  degree.  He  must  in  some  way 
find  a  safety  valve. 

There  must  be  some  way  to  relieve  this  constantly  increas- 
ing pressure  and  the  patient  finds  temporary  relief  by  taking 
alcohol,  which  not  only  dilates  the  blood  vessels  of  the  skin, 
relieving  the  blood-pressure,  but  also  benumbs  the  higher 
sensibilities  so  that  they  are  not  susceptible  to  the  fears,  wor- 
ries, anxieties,  griefs,  and  disappointments  that  were  pre- 
viously harassing  the  mind.  In  this  way,  alcohol  affords  a 
welcome  temporary  relief  to  the  distracted  nerves  of  the 
restless  victims  of  the  high-pressure  life.  But  this  method  of 
relieving  high  tension  is  wholly  false,  for  one  of  the  after- 
effects of  alcohol  is  the  hardening  of  the  arteries ;  so  that  in 
the  end  alcohol  only  serves  to  raise  the  pressure  and  make 
matters  worse. 

3.  The  bromids,  headache  powders,  etc. —  Hand  in  hand 
with  the  enormous  consumption  .of  tea  and  coffee,  there  is 
found  the  steadily  increasing  use  of  the  various  quieting  prep- 
arations and  combinations  of  the  bromids. 

Tea  and  coffee  raise  the  blood-pressure  — the  bromids  and 
their  compounds,  as  a  general  rule,  by  their  sedative  action, 
lower  the  blood-pressure;  and  so,  just  as  alcohol  and  tobacco 
play  their  victim  into  each  other's  hands,  the  heavy  and 
habitual  users  of  tea  and  coffee  find  deceptive  relief  in  the 
use  of  bromids,  coal-tar  preparations,  aspirin,  etc. 


TREA TMENT  OF  "  OLD-AGE  "  DISORDERS         179 

We  cannot  look  to  drugs  for  our  help  in  dealing  with  high 
blood-pressure  and  "  old-age  "  disorders.  We  must  work  for! 
prevention  by  enlightenment ;  for  the  early  detection  of  these 
degenerative  disorders  by  means  of  periodic  medical  and 
dental  examinations ;  and  then  apply  the  best-known  scientific 
methods  to  the  treatment  and  cure  of  the  disorder  if  it  has 
already  overtaken  us. 

SUMMARY  OF  THE  CHAPTER 

1.  Of  all  possible  remedies,  none  can  compare  with  pre- 
vention.   In  the  prevention  of  premature  deaths  from  "  old- 
age  "  disorders,  three  things  are  necessary : 

a.  Reformation  in  personal  habits  of  living. 

b.  The  removal  of  all  focal  infections. 

c.  Thoroughgoing  periodical    or   annual    medical    ex- 
t     amination. 

2.  High  blood-pressure  accompanies  and  is  indicative  of 
most  of  these  troublesome  ailments. 

3.  One  of  the  best  methods  of  combating  the  early  stages 
of  high  pressure  is  to  be  found  in  various  forms  of  outdoor 
physical  exercise. 

4.  Massage  and  other  forms  of  passive  exercises  are  also 
helpful  in  dealing  with  most  cases  of  high  tension. 

5  Neutral  baths  and  cold  friction  are  helpful  in  low- 
ering blood-pressure  as  also  are  short  cold  baths. 

6.  The  sun  bath  is  one  of  the  best  remedies  for  high 
blood-pressure,  if  the  head  is  properly  protected. 

7.  Sleep,  rest,  and  relaxation  are  invaluable  in  overcoming 
nervous  tension  and  high  pressure. 

8.  Cheerfulness  and  religious  trust  are  influential  in  the 
treatment  of  the  nervous  element  in  the  causation  of  these 
high-pressure  disorders. 

9.  Faith  is  a  real  remedy.     Good  cheer  is  a  powerful 
medicine.    Confidence  is  the  climax  of  power  in  the  psychic 
battle  against  the  high-pressure  life. 

10.  Good  digestion,  dietetic  simplicity,  and  simple,  normal 
habits  of  living  are  essential  to  a  natural  and  long  life. 


l8o  RACE  DECADENCE 

11.  The  general  diet  of  kidney  disorders  and  high  arterial 
tension  includes:  fruits,  vegetables,  dairy  products,  cereals, 
with  but  a  small  amount  of   meats,   nuts,   and  all  highly 
seasoned  foods. 

12.  Water  should  be  taken  freely  except  in  serious  kid- 
ney involvement.     In  many  cases  it  is  best  to  live  on  milk 
for  a  number  of  weeks. 

13.  Study  to  avoid  eating  too  many  acid-forming  foods. 
Arrange  the  diet  so  that  the  alkaline  ash-forming  foods  pre- 
dominate. 

14.  If  you  have  syphilis  treat  it  thoroughly,  and  keep 
at  it  until  you  are  pronounced  cured. 

15.  X-ray  all  the  teeth  and  any  other  part  of  the  body 
in  which  the  presence  of  pus  is  suspected. 

1 6.  Search  out  and  remove  every  possible  "  little  fox," 
which   might    exert   an   influence   towards   hardening    the 
arteries  and  raising  the  blood-pressure. 

17.  Familiarize  yourself  regarding  normal  blood-pressure 
and  the  possible  causes  for  high  tension  and  conscientiously 
avoid  those  things  which  cause  premature  old  age  and  death. 

1 8.  There  are  a  vast  number  of  disorders  and  states  which 
affect  blood-pressure,  some  raising,  and  others  lowering  it. 

19.  There  are  numerous   harmful  methods  of   lowering 
blood-pressure  such  as:    morphine,  alcohol,  bromids,  coal- 
tar  products,  etc. 


s 


CHAPTER  XIII 
THE  LAWS  OF  HEALTH  IN  A  NUTSHELL 

I.    GENERAL   PRINCIPLES   OF    HYGIENE 

1.  "  Whatsoever  a  man  soweth,  that  shall  he  also  reap,"  is 
just  as  true  of  the  body  as  it  is  of  the  soul. 

2.  Science  is  rapidly  achieving  the  conquest  of  all  "  germ 
diseases,"  while  the  "  habit  diseases,"  due  to  personal  habits 
and  practices,  are  alarmingly  on  the  increase. 

3.  Nature  alone  can  cure  disease.     Doctors  cannot  heal. 
They  can  only  direct  the  sufferer  back  to  the  pathways  of 
health.    Nature  alone  can  create,  and  healing  is  re-creation. 

4.  Sensations  of  fatigue  and  pain  are  friendly  voices  of 
warning.    They  are  the  body's  conscience.    We  should  heed 
their  messages  and  not  silence  their  prayer  by  stimulants, 
narcotics,  and  pain  killers. 

5.  We  enjoy  health  when  the  body  works  under  natural 
and  normal  conditions.     The   same  laws   of   life  produce 
disease  when  the  body  is  compelled  to  do  its  work  under 
unnatural  and  abnormal  conditions. 

6.  It  should  be  remembered  that  the  human  body  is  a 
great  commonwealth.      These   tiny   little   creatures   called 
cells,  estimated  to   number  more  than  26,ooo,ooo,cxx),ooo, 
are  dependent  upon  man's  common  sense  and  judgment  for 
their  life  and  health. 

7.  Unperverted  instincts  and  natural  appetites  would  prove 
to  be  safe  and  unerring  guides  in  choosing  the  way  of  life, 
but  the  civilized  man,  through  physical   disobedience  and 
artificial  living,  has  grossly  perverted  his  natural  instincts  — 
largely  lost  his  "  horse  sense." 

181 


1 82  RACE  DECADENCE 

8.  Some  persons  have  inherited  such  vast  riches  of  physi- 
cal wealth  that  they  are  able  to  live  a  long  time  as  hygienic 
spendthrifts,  with  but  little  personal  suffering.  The  result 
of  their  careless  living  usually  appears,  however,  later  in 
life;  or,  when  they  are  called  upon  to  pass  through  some 
crisis  due  to  accident,  infection,  etc. 

II.   SUNLIGHT  AND  FRESH   AIR 

1.  Sunshine  is  essential  to  human  life  and  health.     The 
daily  sun  bath,  properly  taken,  would  restore  many  semi- 
invalids  back  to  health. 

2.  Sunshine  is  the  best-known  disinfectant.     It  should  be 
freely  admitted  to  every  human  dwelling  place. 

3.  Our  dwellings  should  be  full  of  windows.    The  house 
should  be  daily  flushed  with  light  and  sterilized  with  sun- 
shine. 

4.  It  is  a  crime  against  the  rising  generation  to  have 
the  nursery  anywhere  except,  on  the   sunny   side  of   the 
house. 

5.  The  direct  rays  of  sunlight  are  almost  instantaneously 
fatal  to  tuberculosis  germs  and  the  vast  majority  of  other 
disease  microbes. 

6.  The  vital  resistance  of  the  human  body  is  greatly  in- 
fluenced by  the   number   of   hours   one  spends   each   day 
in  the  sunshine  or  the  open  air. 

7.  Man  is  an  outdoor  animal.    He  was  made  to  live  in  a 
garden,  not  a  house.     Remember  that  each  person  requires 
one  cubic  foot  of  fresh  air  every  second. 

8.  Remember  that  sleeping  outdoors  is  a  preventive,  as 
well  as  a  cure,  for  tuberculosis;  and  that  foul  air  is  the 
curse  of  many  of  our  modern  manufacturing  establishments 
and  workshops ;  not  to  mention  churches,  schools,  audience 
rooms,  and  other  public  buildings. 

9.  Don't  allow  the  temperature  of  living  rooms,  during 


THE  LAWS  OF  HEALTH  IN  A  NUTSHELL         183 

the  winter  season,  to  go  above  68°  F.  See  to  it  that  the 
air  is  properly  humidified.  Moisture  is  just  as  essential  as 
purity. 

10.  The  vital  resistance  of  an  individual,  a  family,  or  a 
race  of  people,  is  in  exact  inverse  ratio  to  the  number  of1 
years  they  have  been  away  from  the  soil. 

11.  If  your  home  has  no  system  of  ventilation,  open  wide 
the  windows  and  doors  several  times  a  day  and  enjoy  the 
blessings  of  a  thoroughgoing  air  flushing. 

12.  Oxygen  is  the  vital  fire  of  life.     Our  food,  however 
well  digested  and  assimilated,  is  just  as  useless  to  the  body 
without  oxygen,  as  coal  is  to  the  furnace  without  air. 

13.  Consumption    (tuberculosis),   pneumonia,   bronchitis, 
pleurisy,   and  catarrh    are   house   diseases.      Neither   man 
nor  any  other  animal  contracts  these  diseases  when  living 
altogether  out-of-doors. 

III.   DEEP    BREATHING 

1.  Deep  breathing  promotes  brain  circulation,  increases 
mental  activity,  favors  healthy  liver  action,  and  aids  diges- 
tion.    Oxygen  is  nature's  tonic. 

2.  Natural  breathing,  like  that  of  the  infant,  results  in 
expansion  of  both  the  chest  and  the  abdomen.    A  flat  chest 
indicates  weak  lungs  and  decreased  physical  efficiency. 

3.  Deep  breathing  empties  the  portal  vessels  of  the  abdo- 
men, the  congestion  of   which   is  the  chief   cause  of   the 
"  blues."     Mouth  breathing  is  either  a  cause  or  result  of 
disease. 

4.  Despondent  people  are  nearly  always  shallow  breath- 
ers.    Bad  breathing  and  worry  go  together.     Getting  ri(? 
of  one  usually  helps  in  overcoming  the  other. 

5.  Shallow  breathing  beclouds  the  mind  by  causing  a  re- 
tention of  blood  poisons,  thereby  placing  heavy  and  unneces- 
sary burdens  upon  the  moral  nature. 


184  RACE  DECADENCE 

6.  Oxygen  is  so  indispensable  to  life,  that  while  we  can 
live  by  eating  only  two  or  three  times  a  day,  we  are  com- 
pelled to  take  "air  lunches  "  twenty  times  a  minute. 

7.  The  lungs  are  nature's  blood  purifiers.    In  the  place  of 
taking  patent  medicines,  eat  good  food,  drink  pure  water, 
ventilate  the  house,  go  outdoors,  and  breathe  deeply. 

8.  Remember  that  it  is  just  as  important  to  have  fresh 
air  at  night  and  proper  ventilation  in  the  winter,  as  at  other 
times.     Night  air  is  just  as  pure  or  a  little  more  so,  than 
day  air. 

9.  Natural  breathing  is  both   a  preventive  and  a  cure 
for  many  forms  of  constipation,  as  the  diaphragm  exerts  a 
downward  pressure  on  the  stomach  and  bowels  of  about 
two  hundred  pounds. 

10.  The  blood  is  purified  and  its  circulation  quickened  by 
deep  breathing.    The  blood  is  the  vital  stream  that  turns  the 
wheels  of  life,  and  should  contain  more,  by  weight,  of  oxygen 
than  it  dees  of  digested  food. 

n.  Use  the  diaphragm  for  breathing.  Don't  breathe 
merely  with  the  top  of  the  chest  like  a  woman  wearing  a 
tight  corset.  Let  the  diaphragm  move  up  and  down  so  as 
thoroughly  to  ventilate  the  bottom  of  the  lungs. 

12.  The  value  of  the  outdoor  life  is  entirely  dependent 
upon  the  intake  of  oxygen.  It  does  no  more  good  to  go  out- 
doors without  exercise  and  deep  breathing  than  it  would 
when  hungry  to  go  to  the  dining-room  table  and  refuse  to 
eat. 

IV.    PHYSICAL    EXERCISE 

1.  Body  work  is  indispensable  to  first-class  brain  work. 
A  daily  sweat  is  valuable  health  practice.     Exercise  is  bet- 
ter  for  the  health   if   it  is  regular,  useful,  pleasant,   and 
agreeable. 

2.  Systematic  physical  exercise  is  absolutely  essential  to 


THE  LAWS  OF  HEALTH  IN  A  NUTSHELL         185 

good  circulation,  sound  digestion,  and  regular  bowel  move- 
ment. 

3.  Man  is  a  working  machine.     The  study  of  anatomy 
suggests  that  he  was  never  made  to  sit  down.    When  tired 
out  the  body  is  best  rested  by  lying  down. 

4.  Indian  clubs,   Delsarte,   etc.,   are  good  exercises   for 
young  girls,  semi-invalids,  and  for  the  cultivation  of  grace. 
Exercise  should  be  systematic,  not  excessive.    Do  not  begin 
what  you  cannot  keep  up. 

5.  You  owe  it  to  yourself  to  learn  how  to  stand,  sit,  and 
walk  properly,  and  how  to  climb  stairs  in  a  healthful  way. 

6.  Physical  exercise  destroys  body  poisons  and  thus  directly 
favors    mental    activity    and    indirectly    lessens    the    moral 
struggle. 

7.  Going  up  and  down  stairs  one  hundred  and  fifty  times  a 
day  is  equivalent  to  walking  six  miles,  and  is  good  exercise 
if  properly  performed. 

8.  The  ideal   exercise  is  walking  outdoors,   five   or  six 
miles  a  day,  the  arms  swinging  freely  while  every  muscle  is 
vigorously  energized. 

9.  In  exercising  for  health,  it  is  the  heavy  movements  that 
count.      Self-resistive  exercises  are  excellent,   as  you   are 
working  against  your  own  muscles  and  not  against  dead 
weight. 

V.    HEALTHFUL   CLOTHING 

1.  Hats  and  other  headdress  should  be  light  and  airy,  while 
thin-soled  shoes  are  dangerous  in  damp  and  cold  weather. 

2.  Avoid  water-proof  clothing  and  water-proof  shoes  as 
far  as  possible.     For  outer  garments,  wool  is  the  best  for 
winter,  while  cotton  serves  best  in  summer. 

3.  In  winter,  clothe  the  extremities  well.     The  primary 
purposes  of  clothing  are  those  of  protection  and  modesty,  not 
adornment  and  display. 


1 86  RACE  DECADENCE 

4.  The  best  material  for  underclothing  is  linen  mesh  with 
cotton  next.    Wool  is  undesirable  for  underclothing. 

5.  The  most  comfortable  summer  clothes  are  those  of  light 
color  and  loose  weave,  with  a  very  thin  dark  lining. 

6.  During  the  winter,  look  out  for  overclothing  the  body. 
Use  furs  with  discretion.    Clothe  the  body  evenly  and  sym- 
metrically. 

7.  Clothing  should  be  physiologic  and  anatomic  —  that  is, 
the  clothes  should  be  made  to  fit  the  body  and  not  the  body 
to  fit  the  clothes. 

8.  The  unhealthy  corsets  worn  by  women  and  the  tight 
belts  by  men,  interfere  with  natural  and  normal  breathing  and 
weaken  the  abdominal  muscles,  thus  predisposing  to  con- 
stipation and  other  disorders. 

VI.   THE  ART  OF  EATING 

1.  Avoid  extremes  of  temperature  in  eating  and  drinking. 
Eat  some  fresh,  raw  food  daily,  such  as  fruits,  vegetables, 
nuts,  or  dried  fruits. 

2.  Thorough  mastication  —  all  things  being  equal  —  is  one 
of  the  great  secrets  of  good  digestion.    The  best  of  foods  are 
injurious  when  overeaten,  and  the  prompt  elimination  of  the 
waste  products  of  the  body  is  equally  important  with  good 
digestion. 

3.  For  the  sake  of  the  teeth  as  well  as  the  digestion, ,  eat 
more    hard  foods.     Eat    pure,    wholesome,    unadulterated 
foods.    Hard  foods  are  also  good  for  improving  the  circula- 
tion of  the  gums. 

4.  The  more  simple  one's  diet,  the  less  the  craving  of  the 
nervous  system  for  unnatural  foods  and  harmful  stimulants. 
Avoid  excess  of  both  sugar  and  salt. 

5.  It  is  quite  impossible  to  have  peace  in  the  head  and  war 
in  the  stomach.    Coarse  eating  and  fine  thinking  are  incom- 
patible. 


THE  LAWS  OF  HEALTH  IN  A  NUTSHELL         187 

6.  Tea  and  coffee  are  stimulants,   they  are  not   foods. 
Their  only    nourishing    property    is    the    sugar  and  milk 
added. 

7.  Remember   that  overeating   of   protein  produces   far 
more  serious  results  in  the  body  than  does  the  overeating  of 
other  food  elements. 

8.  Remember  that  digestion  is  powerfully  influenced  by 
the  mental  state.    Keep  the  mind  cheerful  and  hopeful  dur- 
ing, and  just  after,  the  meal  hour. 

9.  The  cook  stove  is  of  great  value  in  cooking  cereals,  but 
it  is  overworked  and  much  abused.    Most  fruits,  vegetables, 
and  nuts  are  better  eaten  raw.     Eat  something  uncooked 
every  day. 

10.  Drinking  at  meals  has  little  to  do  with  digestion  in  the 
case  of  most  well  people.     Some  do  better  with  liquids  — 
some  are  better  without. 

11.  Engineers  know  how  to  feed  their  furnaces  better, 
and  farmers  know  how  to  feed  their  cattle  better,  than  the 
average  man  knows  how  to  feed  his  own  body. 

12.  Eat  natural  foods,  cultivate  your  taste,  and  the  ap- 
petite will  in  time  become  a  fairly  reliable  guide  as  to  when 
to  eat,  what  to  eat,  and  how  to  eat. 

13.  The  American  people  eat  too  much  meat.     That  is, 
they  take  too  much  protein.    Other  foods  containing  protein 
are  cheese,  eggs,  beans,  and  most  nuts. 

14.  Study  foods  and  learn  how  properly  to  balance  your 
daily  ration.    The  average  man  requires  about  2,000  calories 
a  day.    Consult  the  food  tables  and  find  out  how  much  you 
are  eating. 

15.  A  good  appetite  ordinarily  equals  a  good  digestion.    If 
the  appetite  is  poor,  make  such  changes  in  your  habits  as 
will  enable  you  to  earn  a  good  one.    A  good  appetite  equals 
good  digestive  juices. 

16.  Multiplicity   of   dishes  tend  to   produce  indigestion. 


1 88  RACE  DECADENCE 

Eat  but  two  or  three  articles  of  food  at  a  single  meal.     If 
you  are  not  hungry  skip  a  meal  now  and  then. 

17.  Remember  that  most  people  eat  too  much  and  eat  too 
often.     That  "  all-gone  "  feeling  in  the  region  of  the  stom- 
ach is  the  cry  of  nature  for  oxygen  or  water,  not  for  food. 
Two  meals  a  day  are  better  for  some  people  than  three. 

18.  Avoid  too  many  highly  seasoned  dishes,  pickles,  and 
the  stronger  condiments  such  as  mustard,  pepper,  and  vine- 
gar —  in  fact  look  with  disfavor  upon  anything  that  is  "  hot  " 
when  it  is  cold.    Remember,  whatever  braces  a  food  against 
decay,  also  braces  it  against  digestion. 

VII.    PURE  WATER  DRINKING  AND  BATHING 

1.  Fresh  fruit  juices  and  lemonade  are  good  beverages  — 
wholesome  and  healthful.    Mineral  waters  have  a  reputation 
which  is  seldom  deserved. 

2.  Remember  that  the  internal  bath  of  the  body  is  just 
as  necessary  and  essential  as  the  external  bath. 

3.  Most  filters  are  a  snare  and  a  delusion,  and  freezing 
water  does  not  necessarily  destroy  disease  germs.     Boil  all 
suspected  drinking  water. 

4.  Cultivate  a  regular  water-drinking  habit.     Most  seden- 
tary people  drink  about  one-fourth  the  water  they  need. 

5.  Examine  the  source  of  your  drinking  water  as  carefully 
as  you  do  the  source  of  your  food  supply.     Look  out  for 
contaminated  water. 

6.  All  the  activities  of  cell  life  are  carried  on  under  water. 
Water  is  indispensable  to  every  nutritional  change.     Life 
cannot  exist  without  water. 

7.  The  daily  intake  of  water  should  equal  the  daily  outgo. 
The  minimum  requirement  according*  to  this  rule,  for  sed- 
entary persons,  is  about  eight  glasses  a  day. 

8.  Cleanse  the  mouth  and  teeth  on  arising  and  after  each 
meal. 


THE  LAWS  OF  HEALTH  IN  A  NUTSHELL         189 

9.  The  neglect  of  regular  bathing  results  in  overworking 
the  liver  and  kidneys,  and  debilitates  the  skin.    For  persons 
who  are  fairly  strong,  the  cold  morning  bath  is  an  excellent 
tonic. 

10.  Hot  baths  are  weakening  and  debilitating  unless  they 
are  finished  off  with  short  applications  of  cold  water. 

1 1 .  Regular  bathing  is  not  a  luxury,  it  is  a  necessity.   The 
skin  should  be  cleansed  by  a  warm  soap  bath  twice  a  week. 

12.  Most  people  will  get  better  results  from  cold  baths  if 
they  are  taken  in  a  warm  room  and  immediately  followed  by 
physical  exercise. 

13.  The  effects  of  short,  cold  baths  are  natural.    This  same 
kind  of  reaction  would  be  spontaneous  in  the  healthy  skin 
exposed  to  the  air.     Baths  are  simply  an  antidote  for  the 
wearing  of  clothes. 

t 

VIII.    REST,    RELAXATION,   AND   RECREATION 

1.  Modern   strenuous   living   of   the  civilized   nations   is 
greatly  raising  the  blood-pressure  and  thereby  predisposing 
to  disease. 

2.  Remember  that  the  defenses  of  the  body  against  dis- 
ease are  greatly  increased  by  leading  the  natural  life  —  the 
simple  life. 

3.  High  blood-pressure  has  more  to  do  with  disease  and 
old  age  than  hard  arteries.    A  man  is  as  old  as  his  arteries 
are  hard  and  his  blood-pressure  is  permanently  raised. 

4.  Remember  that  the  blood-pressure  is  raised  by  cocaine, 
tobacco,  tea,  coffee,  strong  condiments,  excess  of  flesh  foods, 
as  well  as  by  constipation,  worry,  anxiety,  and  other  morbid 
states,  including  moral  condemnation. 

5.  The  white  blood  cells  constitute  the  body's  standing 
army  for  the  resistance  of  infectious  diseases.     Remember 
that  the  function  of  these  cells  is  perverted  and  destroyed  by 
alcohol,  morphine,  quinine,  and  many  other  drugs,  as  well  as 


190  RACE  DECADENCE 

by  the  poisons  of  dyspepsia,  and  constipation  absorbed  from 
the  bowel. 

6.  Don't  take  drugs  for  worry  and  sleeplessness.    Take  a 
warm  bath.     The  American  people  sleep  too  little  and  eat 
too  much. 

7.  Regular  rest  is  essential  to  the  health  of  mind  and  body. 
Make  your  weekly  Sabbath  just  as  complete  a  day  of  rest 
and  recreation  as  possible. 

8.  Cultivate  the  art  of  living  with  yourself  as  you  are,  and 
with  the  world  as  it  is.    Remember  that  worry  about  busi- 
ness, social,  or  industrial  affairs  can  never  help. 

9.  The  secret  of  deliverance  from  worry  is  self-control. 
Minimize  your  difficulties.    Cultivate  faith  and  trust. 

10.  It  is  a  great  mistake  to  fight  sleeplessness  with  drugs. 
In  the  end  the  drugs  themselves  will  produce  more  insom- 
nia.   The  average  man  requires  about  eight  hours  of  sound 
sleep  every  night. 

11.  Shun  worry  and  all  its  mental  cousins  as  you  would 
flee  from  the  smallpox.    There  is  no  trouble,  however  seri- 
ous, worrying  over  which  will  do  any  good. 

12.  Take  a  half  day  off  in  the  middle  of  the  week  if  you 
can  get  it.     Spend  it  in  wholesome  recreation,  in  the  culti- 
vation of  health,  and  in  making  other  people  happier. 

13.  To  rob  one's  self  of  sleep  is  simply  putting  a  mortgage 
on  future  health  and  happiness.    Nature  is  sure  to  foreclose 
it  and  you  will  be  required  to  pay  compound  interest. 

14.  The  conditions  which  favor  sound  sleep  are:  quiet, 
mental  peace,  pure  blood,  good  digestion,  fresh  air    (the 
colder  the  better),  an  empty  stomach,  physical  weariness  ^(but 
not  fatigue),  mental  weariness  (but  not  worry). 

15.  The  physiologic  resting  posture  is  with  the  body  recum- 
bent,   resting   upon  either   side,   perhaps    slightly   inclined 
toward  the  abdomen.    The  emptying  of  the  stomach,  if  one 
has  eaten  at  a  late  hour,  and  the  action  of  the  heart,  are  fa- 


THE  LAWS  OF  HEALTH  IN  A  NUTSHELL          191 

vored  by  sleeping  on  the  right  side.     There  are  numerous 
reasons  for  not  sleeping  on  the  back. 

1 6.  Waking  up  tired  in  the  morning  after  having  slept  all 
night  is  significant  and  means  one  or  more  of  three  things : 

a.  Auto-intoxication  —  that  is,  self -poisoning  from  the 
accumulation  of  body  poisons  in  the  blood-stream. 

b.  Nervous  exhaustion  —  a  physical  condition  verging 
toward  the  borderland  of  brain-fag  or  nervous  pros- 
tration. 

c.  Habitual  worry,  despondency,  or  some  other  mental 
attitude  of  fear  and  grief.     Remember,  sleep  is  an 
antidote  for  work,  but  not  for  worry. 

IX.    THE  PREVENTION  OF  DISEASE 

1.  Consumption  is  largely  spread  by  careless  spitting.  Ag- 
itate against  it.    Avoid  using  towels  and  other  toilet  articles 
which  have  been  used  by  others. 

2.  Remember  that  the  mosquito  is  the  means  of  spreading 
both  malaria  and  yellow  fever.    Next  to  germs  themselves, 
the  great  cause  of  disease  is  insanitary  surroundings. 

3.  Look  out  for  dust.    House  dust  is  especially  dangerous. 
Dust  is  the  airship  of  the  microbe. 

4.  Remember  that  typhoid  fever,  summer  diarrhea,  etc., 
come  largely  from  contaminated  water,  milk,  and  food. 

5.  All  closets   not  having  sewer  connections   should  be 
carefully  screened  to  prevent  flies  gaining  access  thereto. 

6.  Children  may  contract  diphtheria,  scarlet   fever,  and 
other  diseases  from  sick  cats,  dogs,  and  other  domestic  pets. 

7.  Avoid  the  public  drinking  cup.     It  is  a  carrier  of  dis- 
ease, and,  for  the  same  reason,  promiscuous  kissing  should 
be  tabooed. 

8.  Fruits  and  vegetables,  when  eaten  raw,  should  be  thor- 
oughly washed  to  remove  the  eggs  of  intestinal  worms  and 
parasites. 


192  RACE  DECADENCE 

9.  The  slums  of  the  great  city,  through  their  vice  and  im- 
morality are  spreading  broadcast  the  dreaded  diseases  of  so- 
cial transgression.     Much  sickness  is  thus  the  result  of  sin. 

10.  Raw  pork   is   dangerous;   it  may   contain  trichinae. 
Rare  beef  may  cause  tapeworm,  while  typhoid  fever  is  con- 
tracted from  infected  raw  oysters. 

11.  The  vast  majority  of  diseases  are  wholly  preventable. 
It  lies  within  the  power  of  man  to  drive  every  germ  disease 
from  the  face  of  the  earth. 

12.  "Rats,  fleas,  and  bedbugs,  together  with  other  animal 
parasites,  are  responsible  for  carrying  many  diseases,  in- 
cluding the  dreaded  bubonic  plague. 

13.  Remember  that  disease  never  comes  without  a  cause. 
Most  acute  diseases  are  caused  by  microbes,  and  the  ma- 
jority of  chronic  disorders  are  caused  by  wrong  habits  of 
living. 

14.  Always  give  hearty  cooperation  to  the  public  health 
officials  in  carrying  out  their  regulations  and  quarantine  re- 
quirements.    They  are  working  for  your  good  as  well  as 
that  of  the  community. 

15.  Remember  that  germs  are  not  attracted  to  the  healthy 
man.     Health  is  more  contagious  than  disease.     Ordinarily, 
we  fall  victims  to  germs  only  after  our  vital  resistance  is 
lowered  by  physical  transgression. 

16.  The  common  house  fly  is  a  dangerous  disease,  car- 
rier, engaged  in  spreading  typhoid  fever  and  half  a  score  of 
other  diseases.     Destroy  both  the  flies  and  their  breeding 
grounds.    Keep  them  out  of  the  house,  and  especially  away 
from  the  food. 


PART  II 

Mental  Degeneracy 

\ 

The  Increase  in  Mental  and  Nervous  Disorders 


CHAPTER  XIV 
ARE  WE  BECOMING  A  NEUROTIC  RACE? 

WHEN  we  hear  so  much  of  neurasthenia  and  nervous 
exhaustion,  when  we  see  so  many  people  afflicted 
with  some  form  of  nervousness,  we  may  be  tempted  to  think 
that  the  American  people  are  becoming  a  race  of  neurotics, 
but  perhaps  things  are  not  as  bad  as  they  seem  on  the  surface. 
As  we  found  in  the  examination  of  statistics  relating  to  the 
increase  in  physical  diseases,  while  they  may  be  disconcert- 
ing, they  are  not,  in  some  instances,  necessarily  unduly  alarm- 
ing. But,  with  all  the  optimism  we  can  muster  up,  as  we 
view  the  situation  in  regard  to  mental  and  nervous  disorders, 
we  must,  in  the  language  of  the  politicians,  "  view  the  same 
with  more  or  less  alarm." 

GENERAL  NERVOUSNESS 

There  is  little  doubt  in  the  author's  mind  but  that  general 
nervousness  is  at  present  on  the  increase.  Primarily,  I  do 
not  think  this  is  altogether  due  to  our  so-called  high-pressure 
living  —  the  fierce  pace  which  the  present  generation  is  set- 
ting in  its  social,  business,  and  even  its  recreational  life.  I 
think  the  fundamental  weakness,  in  so  far  as  the  nervous  sys- 
tem is  concerned,  is  largely  hereditary,  and  that  our  all- 
round  fast  living  is  merely  a  contributing  factor  which 
earlier  and  more  completely  develops  and  makes  manifest 
these  various  nervous  disorders  and  weaknesses,  which  are 

i9S 


1 96  RACE  DECADENCE 

but  evidences  of  heredity  that  is  nervously  weak  and  consti- 
tutionally inferior. 

These  victims  of  nervousness  suffer  from  a  great  assort- 
ment of  neurologic  difficulties  and  complaints,  and  are  tor- 
tured and  tormented  by  a  vast  array  of  mental  and  nervous 
sufferings  or 'symptoms.  They  embrace  the  chronic  worrier, 
the  individual  whose  mind  seems  to  travel  over  a  circuit  of 
troubles,  both  imaginary  and  real.  Among  these  nervous 
sufferers  are  found  the  victims  of  definite  dreads,  crystallized 
fears,  and  an  endless  assortment  of  both  motor  and  mental 
obsessions,  not  to  mention  those  who  are  hyper-conscien- 
tious, who  are  never  able  to  please  themselves  with  even 
their  best  efforts,  together  with  a  large  number  of  individu- 
als who  take  everything  too  seriously,  not  excepting  them- 
selves. 

Perhaps  none  of  us  are  perfect  when  it  comes  to  the  con- 
trol of  our  nerves  and  the  management  of  our  habits.  Per- 
haps we  are  all  more  or  less  a  bit  nervous  at  times.  I  have 
sometimes  thought  these  nervous  people  were  little  different 
than  the  rest  of  us,  only  they  make  a  special  business  of  pick- 
ing out  these  undesirable  nervous  manifestations,  and  so  con- 
centrate their  minds  upon  them  as  to  make  it  a  sort  of  a  habit 
in  their  experience.  All  of  us  get  tired,  but  we  rest  up  and 
forget  it.  These  people  carry  it  over  from  one  day  to  an- 
other, and  make  almost  a  combined  religion  and  business  of 
being  sick,  of  spying  on  themselves  and  thinking  incessantly 
of  their  unpleasant  symptoms  and  disagreeable  sensations. 

NEURASTHENICS 

Neurasthenia  is  on  the  increase,  and  it  seems,  to  be  an  indi- 
cation of  a  deterioration  in  the  fundamental  fiber  of  the 
American  stock.  I  don't  believe  that  people  merely  worry 
more  than  th«y  used  to  because  of  the  increasing  and  chang- 
ing vicissitudes  of  life,  but  that  more  people  are  actually 


ARE  WE  BECOMING  A  NEUROTIC  RACE?         197 

born  neurologically  disinherited.  I  regard  the  increasing 
neurasthenic  tendencies  of  the  age  as  another  evidence  point- 
ing toward  race  degeneracy. 

By  neurasthenics  we  refer  to  those  people  who  are  suffer- 
ing from  a  habitual  state  of  nervous  fatigue,  due  quite  en- 
tirely to  functional  nervous  causes.  These  neurasthenics 
must  not  be  confused  with  that  general  nervousness  which  is 
so  often  associated  with  various  organic  diseases  such  as  tu- 
berculosis, Bright's  disease,  diabetes,  or  other  real  bodily  ail- 
ments. Neurasthenia  is  not  a  disease,  in  and  of  itself,  as  we 
commonly  understand  the  term;  it  is  merely  a  functional 
nervous  disorder,  indicating,  on  the  one  hand,  inheritance  of 
a  poorly  balanced  nervous  system,  and,  on  the  other,  a  lack 
of  sufficient  control  over  this  more  or  less  un-normal  nervous 
mechanism. 

t  SYMPTOMS  OF  NEURASTHENIA 

Neurasthenia  is  characterized  by  great  nervous  irritability 
and  by  mental  or  nervous  fatigue  out  of  all  proportion  with 
what  could  be  expected  from  normal  mental  and  physical  ac- 
tivities. This  constant  fatigue,  which  is  sometimes  very 
much  worse  upon  first  arising  in  the  morning,  is  accompa- 
nied by  a  vast  assortment  of  unpleasant  sensations  and  other 
symptoms  in  the  head  and  various  parts  of  the  body.  This 
fatigue  is  usually  very  much  less  as  the  day  wears  on,  more 
particularly  in  the  evening  after  supper.  Neurasthenics  seem 
to  be  improvident  in  storing  up  their  nervous  energy,  or 
else  extravagant  in  expending  it;  at  least  they  are  always 
short  —  suffering  from  lowered  nerve  tone.  Among  the 
minor  nervous  symptoms  which  afflict  these  patients  may  be 
mentioned  a  series  of  functional  nervous  disturbances 
embracing  headache,  backache,  insomnia,  dyspepsia,  and 
chronic  constipation,  not  to  mention  a  host  of  sensory  trou- 
bles which  are  often  most  annoying  and  which  manifest 


198  RACE  DECADENCE 

themselves  in  the  skin  variously  as  itching,  pricking,  burn- 
ing, creeping,  crawling,  and  other  abnormal  sensations. 

EARMARKS   OF   NEURASTHENIA 

Aside,  then,  from  the  characteristic  neurasthenic  fatigue 
and  the  before  mentioned  numerous  symptoms  or  sensory 
vagaries,  the  neurasthenic  state  is  marked  by  four  cardinal 
and  characteristic  symptoms : 

1.  Increased  suggestibility. —  The  patients  are  prone  to 
think  they  have  any  and  all  diseases  they  hear  or  read  about. 

2.  Oversensitiveness. —  Their    feelings   are   always   being 
hurt.    They  seem  to  wear  their  feelings  all  on  the  outside  of 
the  body  in  the  skin. 

3.  Abnormal    impressibility. —  They    are    overimpressed 
with    everything    that   happens,    not    excepting    their    own 
thoughts  and  feelings. 

4.  Increased  emotionalism. —  They  often  cry  if  you  point 
a  finger  at  them,  and  sometimes  weep  if  you  don't. 

All  of  this  mental  and  nervous  condition,  of  course  brings 
about  a  state  of  mental  confusion  —  disturbance  of  mem- 
ory—  and  this  sometimes  gives  the  patients  great  concern. 
They  feel  that  they  are  on  the  sure  and  quick  road  to  in- 
sanity, and  of  course  it  goes  without  saying  they  find  it  diffi- 
cult to  "  make  up  their  minds :"  that  is,  decision  is  greatly 
delayed,  terribly  hampered,  and  they  sometimes  wear  them- 
selves out  trying  to  decide  whether  to  get  a  soft  hat  or  a  stiff 
hat,  or  whether  to  set  the  black  hen  or  the  Dominique  hen. 

IMAGINARY  SUFFERING 

Some  of  our  nervous  patients  are  very  fastidious  about 
their  sensations  and  pains,  and  of  course  they  are  exceedingly 
sensitive  if  anyone  intimates  that  the  trouble  is  in  the  "  head," 
or  that  it  is  "  imaginary ; "  they  want  no  one  for  a  moment 
to  presume  that  their  sufferings  are  not  real,  even  when  they 


ARE  WE  BECOMING  A  NEUROTIC  RACE?         199 

are  imaginary.  An  imaginary  disease  may  not  be  real,  but  a 
diseased  imagination  is  one  of  the  realest  things  on  earth. 
These  people  may  be  suffering  the  tortures  of  the  damned, 
even  while  the  doctor  looks  them  straight  in  the  eye  and  as- 
sures them  that  there  is  nothing  at  all  wrong.  Imaginary 
suffering,  psychic  sensation,  and  fictitious  pain,  may  mean 
something  to  the  nerve  specialist,  but  they  mean  nothing  to 
the  victims  of  "  nerves."  They  continue  to  be  literally  tor- 
tured by  these  various  sensations  of  which  they  are  abnor- 
mally conscious,  and  which  they  sometimes  call  pain,  re- 
gardless of  the  terms  which  the  medical  diagnostician  may 
apply  to  their  ailments. 

These  nervous  sufferers  may  get  into  the  habit  of  being  in 
pain  or  in  chronic  misery.  Their  threshold  for  the  recognition 
of  pain  may  indeed  become  so  lowered,  so  enormously  de- 
pressed, that  the  ordinary  and  normal  sensations  of  physio- 
logic life  passing  over  their  nerves  may  be  recognized  as  pain 
and  may  be  the  occasion  of  actual  suffering  on  the  part  of 
these  unfortunate  creatures.  That  is,  nervous  patients  can 
get  in  that  perverted  and  abnormal  state  of  mind  and  body 
where  they  will  recognize  the  sensations  which  the  most  of 
us  regard  with  pleasure  and  look  upon  as  normal  —  I  say 
where  they  will  recognize  these  same  normal  sensations  as  a 
source  of  suffering,  as  bona  fide  miseries  of  the  body,  some- 
times even  insisting  that  they  are  actually  painful.  It  is 
quite  easy  for  these  sufferers  to  take  from  one  to  two  hours, 
whenever  occasion  offers  itself,  to  tell  their  friends  or  their 
physician  the  story  of  their  sufferings  in  the  minutest  detail. 
It  becomes  a  habit  with  them,  a  mania,  and  this  has  no  doubt 
led  to  the  unfeeling  pleasantry  that  some  of  these  unfor- 
tunates actually  come  to  the  place  where  they  "  enjoy  poor 
health." 

The  author  believes  that  heredity  is  the  real  basis  for  most 
of  our  neurasthenic  manifestations.  Environment  simply 


200  RACE  DECADENCE 

serves  to  develop  and  bring  forth  these  numerous  latent  but 
inherent  tendencies. 

PSYCHASTHENIA 

The  psychasthenes  are  those  who  suffer  from  inherited 
neurasthenia  —  true  brain-fag.  They  are  the  people  who 
are  "  born  tired,"  and  are  never  really  able  to  get  over  it. 
I  believe  that  the  number  of  psychasthenes  in  our  popula- 
tion is  steadily  increasing,  and  while  psychasthenia  is  not,  in 
many  ways,  very  different  from  neurasthenia,  it  is  not  so 
easy  to  get  away  from  or  cure,  and  it  represents  the  be- 
havior of  a  nervous  system  that  will  remain  more  or  less 
psychasthenic  throughout  one's  lifetime. 

The  psychasthenic's  symptoms  are  more  truly  mental  than 
are  those  of  the  neurasthenic.  The  psychasthene  usually 
complains  of  being  fatigued  or  worn  out,  since  15  or  1 6  years 
of  age,  though  he  may  be  otherwise  in  a  state  of  excellent 
health.  The  psychasthenes  do  not  have  to  have  stress  and 
strain  or  sickness  to  bring  on  their  trouble  —  it  just  comes  on 
naturally,  just  like  water  runs  downhill.  In  many  ways  they 
behave,  and  react  to  their  environment,  like  a1  child  would, 
unless  the  occasion  is  really  one  that  demands  large  thinking 
and  big  action;  then,  as  a  rule,  they  meet  it  bravely,  for  the 
time  being  forget  their  troubles,  but  relapse  back  into  a  state 
of  complaining  and  fatigue  as  soon  as  the  crisis  is  past. 

Psychasthenia  is  a  true  inheritance  of  racial  stock ;  it  is  a 
part  of  our  ancestry,  a  sort  of  defect  in  hereditary  evolution, 
and  therefore  overtakes  us  without  will  or  leave.  Our  per- 
sonal responsibility  is  only  concerned  in  and  with  those 
methods  and  measures  which,  on  the  one  hand  tend  to  make 
the  situation  worse,  or,  on  the  other,  assist  in  overcoming  na- 
ture's handicap,  thus  enabling  the  psychasthenic  victim  to 
make  a  creditable  showing  with  an  otherwise  abnormal 
mechanism  and  a  greatly  curtailed  nervous  capital. 


ARE  WE  BECOMING  A  NEUROTIC  RACE?         201 
PSYCHASTHENIC  SYMPTOMS 

Many  of  these  individuals  who  are  born  tired,  if  they  are 
raised  in  the  country  or  amidst  rural  surroundings,  do  very 
well  and  make  good  in  life.  They  do  not  do  so  well  in  the 
swift  channels  of  commerce  and  society  which  characterize 
the  larger  cities.  There  they  are  more  likely  to  break  down, 
"  go  wrong,"  or  "  blow  up."  It  is  quite  largely  from  the 
psychasthenes  of  the  nation  that  the  ne'er-do-wells  of  mod- 
ern society  are  recruited.  The  majority  of  our  inveterate 
and  incurable  tramps  are  afflicted  with  this  psychasthenic 
taint,  as  are  also  those  scions  of  certain  aristocratic  and 
wealthy  families  who  are  now  and  then  so  strikingly  at- 
tacked with  the  wanderlust.  So  it  would  really  seem  that  this 
term  "  psychasthenia  "  might  be  pressed  into  service  for  the 
purpose  of  courteously  describing  a  certain  stratum  of  mod- 
errt  society  which  might  otherwise  commonly  and  vulgarly  be 
called  "lazy." 

The  psychasthene's  chief  trouble,  after  all,  is  not  merely 
the  ever-present  and  pressing  fatigue,  but  also  a  general  in- 
capacity for  doing  things,  coupled  with  the  everlasting  habit 
of  over-attention  to  everything  connected  with  his  thinking, 
living,  feeling,  and  working.  The  psychasthene  spends  the 
larger  part  of  his  mental  effort  and  nervous  energy  in  watch- 
ing himself  and  otherwise  trying  to  help  himself  in  carrying 
on  those  varied  mental  and  physical  processes  which  nature 
intended  to  be  automatically  executed.  Thus  his  nervous 
energy  is  almost  wholly  consumed  on  himself,  in  a  useless 
and  thoroughly  harmful  manner.  In  other  words,  the  psy- 
chasthene is  chronically  guilty  of  "  spying  on  himself."  He 
cannot  let  his  mind  think  or  his  stomach  work  without  watch- 
ing it.  He  is  even  guilty  of  trying  to  watch  himself  go  to 
sleep,  which  of  course  never  fails  to  spell  insomnia. 

But  it  is  surprising  what  education  and  training,  develop- 


202  RACE  DECADENCE 

ment  of  decision  and  improvement  of  will-power  will  do  for 
some  of  these  psychasthenic  patients.  They  learn  to  forget 
their  ever-present  fatigue  and  their  nervous  sensations.  They 
are  able  to  train  themselves  to  go  about  their  business  and 
to  come  just  about  doing  a  real  man's  or  a  real  woman's 
work  in  the  world,  so  that  after  all  some  of  them  turn  out  to 
be  very  efficient  workers,  and  to  be  quite  happy  and  contented 
with  their  lot.  The  majority  of  them  are  really  able  to 
master  the  art  of  living  with  themselves  as  they  are  and  the 
world  as  it  is. 

HYSTERIA 

Our  utter  carelessness  and  indifference  as  to  who  mar- 
ries, in  this  country,  is  not  only  contributing  to  an  increase 
in  our  markedly  defective  stock,  but  is  also  leading  to  an  un- 
doubted increase  in  all  of  the  lesser  forms  of  nervousness, 
including  hysteria.  And  what  is  hysteria?  The  answer  is 
difficult.  In  olden  times  it  was  called  demoniacal  possession, 
witchcraft,  and  what  not.  Hysteria,  as  a  disease  or  a  nervous 
disorder,  must  not  be  confused  with  mere  hysterics,  which 
any  neurotic  person  may  indulge  in  from  time  to  time.  Hys- 
teria is  far  more  of  a  grave  disorder  than  hysterics.  Most 
nervous,  uncontrolled,  neurasthenic  individuals  may  get  hys- 
terical at  times,  but  this  would  not  warrant  a  diagnosis  of 
hysteria. 

The  older  physicians  were  tempted  to  look  upon  hysteria 
as  a  malady  that  was  largely  feigned;  as  a  .fictitious  sort  of 
disease  performance  on  the  part  of  certain  sorts  of  nervous 
and  emotional  women.  Men  were  not  supposed  to  have  the 
disorder  unless  they  were  somewhat  effeminate.  Doctors 
disagree  as  to  what  hysteria  really  is,  but  I  have  come  to  look 
upon  it  as  a  sort  of  hereditary  deficiency  in  nervous  self- 
control  ;  at  least  the  tendency  is  hereditary.  It  is  a  mild  dis- 
order of  personality  and  occurs  in  those  individuals  who  are, 


ARE  WE  BECOMING  A  NEUROTIC  RACE?         203 

by  heredity,  highly  suggestible,  on  the  one  hand,  and  who 
possess  a,  small  degree  of  self-control  on  the  other.  It  is 
something  more  than  neurasthenia,  it  is  more  deeply  rooted 
than  the  mere  nervous  disorders.  It  comes  nearer  being  a 
part  of  one's  real  temperament  and  personality.  There  seems 
to  be  at  times  a  real  mental  insufficiency,  which  results  in  the 
sympathetic  nervous  system  engaging  in  various  wild  and 
sort  of  runaway  performances  affecting  various  parts  of  the 
body  and  the  patient's  general  behavior.  During  these  at- 
tacks the  disorder  manifests  itself  by  producing  many  and 
diverse  symptoms,  and  is  able  in  one  way  or  another  to  im- 
personate almost  every  known  form  of  human  illness.  And 
of  course  it  is  true  that  an  uncontrolled  imagination  often 
plays  a  large  and  important  part  in  the  manifestations  of 
this  perplexing  disorder. 

Hysteria  is,  then,  briefly  summarized,  a  nervous  disorder 
occurring  chiefly  in  women,  characterized  by  lack  of  control 
over  the  emotions  and  certain  physical  acts,  by  morbid  self- 
consciousness,  by  exaggeration  of  all  sensory  impressions, 
and  by  extraordinary  ability  to  simulate  the  symptoms  of 
numerous  diseases,  and  thus  to  impersonate  a  host  of  minor 
and  major  physical  disorders. 

THE  HEREDITARY  NATURE  OF  HYSTERIA 

Hysteria,  whether  it  is.'  the  phenomenon  of  the  imagina- 
tion playing  the  role  of  the  actor;  whether  it  is  partial  dis- 
sociation of  ideas,  deranged  nervous  control,  or  disturbances 
of  personality;  whether  it  is  temporary  insanity  of  the  sym- 
pathetic nervous  system,  or  what  not;  it  is  certainly  a  dis- 
order that  is  largely  hereditary.  Whatever  the  causes  of 
stress  and  strain,  nervous  tension,  anxiety  or  worry,  or 
whatever  the  bodily  habits  or  physical  vices  which  may  di- 
rectly or  indirectly  contribute  to  the  outbreaks,  attacks,  or 
spells  of  hysteria,  the  fundamental  and  underlying  fact  re- 


204  RACE  DECADENCE 

i  , 

mains  —  the  disease  is  hereditary  and  is  certainly  transmissi- 
ble in  some  form  or  other  to  the  next  generation. 

While  it  is  true  that  neurasthenia,  psychasthenia,  and  hys- 
teria probably  do  not  tend  to  go  down  the  line  with  the  same 
unerring  accuracy  as  do  feeble-mindedness  and  insanity; 
nevertheless,  when  two  individuals  who  are  highly  neurotic 
marry  it  is  common  observation  that  the  majority  of  their 
children  are  almost  equally  neurotic  or  more  so.  Now  when 
these  neurotic  persons  are  mated  with  normal  or  nervously 
superior  individuals,  there  usually  occurs  great  improvement 
in  the  majority  of  the  offspring.  So  we  are  encouraged  by 
the  fact,  or  by  the  belief,  at  least,  that  these  less  serious  nerv- 
ous disorders  have  a  tendency  to  "  breed  out "  of  the  stock 
rather  than  to  increase  in  intensity  and  severity  with  succes- 
sive matings.  Many  of  these  nervous  traits  seem  to  behave 
after  the  fashion  of  Mendelian  recessions.  This  fact  prob- 
ably explains  why  we  are  not  cursed  with  more  defectives  of 
the  nervous  sort,  in  view  of  our  utter  indifference  to  improve- 
ment of  our  marriage  laws  and  other  eugenic  precepts.  But, 
notwithstanding  these  favorable  features  regarding  the  in- 
heritance of  these  disorders,  it  is  the  common  belief  of  phy- 
sicians and  specialists  who  handle  these  troubles  that  they 
are  considerably  on  the  increase  in  America  at  the  present 
time. 

SYMPTOMS    OF    HYSTERIA 

The  symptoms  of  hysteria  are  too  many  and  varied  to  cat- 
alogue. As  has  been  intimated,  these  patients  can  simulate 
the  manifestations  of  almost  any  and  every  known  disease, 
ranging  from  a  fit  of  bad  temper  to  complete  unconsciousness 
or  catalepsy,  on  the  mental  and  nervous  side ;  and  from  sim- 
ple perversion  of  skin  sensation  down  through  headache  and 
all  sorts  of  pains  to  apparent  appendicitis  and  gallstone 
colic  on  the  physical  side.  And  in  many  cases,  in  connection 


ARE  WE  BECOMING  A  NEUROTIC  RACE?          205 

with  the  periodical  manifestations  of  this  disorder,  there  is 
to  be  found  more  or  less  emotional  repression,  lack  of  ade- 
quate self-expression.  Many  cases  of  hysteria  are  also  as- 
sociated with  some  conscious  or  subconscious  sex  disorder  — 
sex  repression.  In  most  instances  where  the  sex  element 
enters  into  the  causation  of  hysteria  or  other  forms  of  ner- 
vousness, the  victims  are  more  or  less  unconscious  of  the 
presence  of  this  factor. 

RACIAL  INSTABILITY 

We  cannot  look  with  equanimity  upon  the  fact  that  the 
racial  stock  of  a  state  or  nation  is  becoming  more  unstable, 
less  self-collected  and  less  self -controlled.  It  is  no  cause 
for  congratulation  that  our  people  are  threatened  with  be- 
coming, individually  and  collectively,  more  and  more  panicky 
and  hysterical.  Normal  nervous  stability  and  that  superb 
self-poise  and  self-control,  which  are  characteristic  of  su- 
perior peoples  in  the  higher  civilized  races,  cannot  be  sacri- 
ficed, even  to  a  small  degree,  through  successive  generations, 
without  jeopardizing  the  future  integrity  and  position  of  any 
race  of  people. 

It  should  not  be  inferred  that  a  race  must  necessarily  be 
stolid,  stoical,  and  unemotional,  in  order  to  be  free  from  hys- 
terical tendency.  A  people  may  have  a  great  inherent  ca- 
pacity for  self-expression,  they  may  have  great  potential 
emotionality,  they  may  indeed  be  warm-hearted  and  truly 
spiritual,  and  at  the  same  time  be  a  great  and  growing  race. 
Let  us  not  be  frightened  by  the  presence  among  us  of  any 
of  these  good  characteristics  of  a  great  nation.  We  should 
only  be  alarmed  by  the  fact  that  there  is  to  be  found  too 
great  a  tendency  to  this  direct  hereditary  instability  of  the 
nervous  system,  and  that,  as  a  people,  if  it  should  continue 
to  increase  throughout  succeeding  generations,  we  are  des- 
tined to  become  a  nation  with  less  self-control,  less  self- 


206  RACE  DECADENCE 

respect,  and  less  inherent  capacity  for  individual  develop- 
ment and  collective  national  greatness. 

HYPOCHONDRIACS 

Under  the  functional  nervous  disorders,  before  we  take  up 
insanity  and  feeble-mindedness,  we  should  also  briefly  note 
hypochondria,  melancholia,  and  the  chronic  "  blues."  Those 
who  suffer  from  these  disorders  usually  have  something 
wrong  with  them  physically  as  well  as  to  be  so  unfortunate 
as  to  have  inherited  a  defective  and  deficient  nervous  system. 
They  are  the  folks  who  have  chronic  dyspepsia  and  bilious- 
ness. They  are  bilious  mentally  as  well  as  physically.  They 
make  a  business  of  being  sick  when  they  are  well,  just  as  a 
Christian  Scientist  makes  a  business  of  being  well  when  he 
is  sick.  They  suffer  a  great  deal  with  burning  sensations 
here  and  indefinite  pains  there.  They  are,  in  a  word,  chronic 
pessimists.  One  thing  characteristic  of  them  is  not  merely 
the  quality  of  their  complaints  but  also  the  fact  that  they  in- 
variably tend  to  exaggerate  even  their  physical  ailments. 
They  are  constantly  preoccupied  with  their  own  troubles,  un- 
erringly self-centered  and  introspective  to  the  highest  degree. 
We  especially  find  these  cases  in  people  of  over  forty  years  of 
age  who  have  no  active  "  job  "  to  interest  and  keep  them 
busy. 

And,  of  course,  these  hypochondriacs  may  go  on  to  the 
verge  of  melancholia,  where  it  is  difficult  to  distinguish  be- 
tween severe  cases  of  hypochondria  and  mild  cases  of  melan- 
cholic insanity. 

CHOREA,  OR  ST.  VITUS*  DANCE 

We  have  a  large  group  of  nervous  disorders  which  do  not 
belong  to  the  so-called  neuroses  on  the  one  hand  or  the  in- 
sanities on  the  other.  Chief  among  these  disorders  is  St. 
Vitus'  dance,  a  disease  frequently  appearing  in  the  offspring 


ARE  WE  BECOMING  A  NEUROTIC  RACE?         207 

of  nervous  parents.  This  disorder  is  too  well  known  to  need 
description,  being  characterized  by  jerky,  involuntary  move- 
ments, and  minor  jerking  of  the  face  and  upper  extremities. 
These  movements  are  not  indulged  in  during  sleep,  or  when 
the  patient's  mind  is  fully  occupied.  On  the  other  hand  they 
are  present  when  the  patient  is  an  object  of  anxious  solici- 
tude or  comment,  either  at  home  or  in  school.  This  condi- 
tion is  very  general  and  undoubtedly  on  the  increase,  not- 
withstanding our  improved  methods  of  treatment  and  the 
fact  that  these  cases  are  now  more  generally  early  isolated 
and  more  effectively  treated. 

TICS  AND  HABIT  SPASMS 

How  frequently  one  sees  on  the  streets,  in  the  trolley  cars, 
or  at  social  gatherings,  persons  who  have  these  minor  nerv- 
ousj  manifestations  commonly  called  "  tics."  Among  these 
disorders  may  be  mentioned  involuntary  winking  of  the 
eyes,  spasmodic  movements  of  the  nose,  the  upper  lip,  and 
other  muscles  of  expression,  not  to  mention  nodding  and 
talking  tics.  Among  the  latter  may  be  mentioned  the  habitual 
utterance  of  such  words  as  "  don't  you  know  "  or  "  listen," 
or  when  hesitating  to  say  "  hum  "  or  "  hem."  These  are  all 
purely  and  simply  verbal  tics.  Then  the  nervous  manner- 
isms and  useless  gestures  of  some  public  speakers  no  doubt 
belong  to  this  disorder,  as  does  also  the  fussiness  and  finicki- 
ness  of  some  other  people  who  must  needs  constantly  play 
with  a  pencil,  a  knife,  or  twirl  their  thumbs,  or  their  hair. 
Others  chew  their  finger  nails  or  pick  the  nose. 

These  manifestations  or  nervous  practices  certainly  run  in 
families.  It  is  probable  that  while  they  are,  in  the  main, 
hereditary,  suggestion  or  example  always  plays  a  large  part. 
If  taken  in  time,  young  people  can  be  cured  of  these  things, 
and  even  the  older  ones  can  help  themselves  by  persistent 
effort. 


208  RACE  DECADENCE 

STAMMERING  AND  STUTTERING 

If  one  reads  the  magazines  today  and  notes  how  man}7 
stuttering  specialists  there  are  and  how  many  stammering 
schools  are  run  for  helping  these  sufferers,  he  would  suspect 
that  stammering  and  stuttering  are  at  least  not  on  the  de- 
crease. They  seem  to  be  on  the  increase.  These  disorders 
are  sometimes  neglected  or  winked  at  in  childhood,  on  the 
supposition  that  the  young  folks  will  outgrow  the  ailment. 
This  is  a  dangerous  practice,  for  it  indicates  inherent  insta- 
bility and  deficient  control  over  the  nervous  system.  Some 
nervous  individuals  acquire  such  a  stuttering  of  the  gullet 
that  they  think  they  are  going  to  choke,  and  are,  for  long 
periods,  afraid  to  eat  solid  food.  Others  stagger  in  their 
walk,  with  no  other  cause  to  explain  their  behavior.  I  once 
had  a  patient  who  had  stuttering  of  the  hand  when  he  came 
to  sign  his  name,  although  he  could  write  anything  else  with- 
out the  least  quiver  of  the  fingers.  I  have  wondered  if  even 
some  forms  of  so-called  "  writer's  cramp  "  didn't  belong  in 
this  category. 

There  are  perhaps  a  dozen  successful  stammering  cures. 
They  are  all  based  on  the  principle  of  getting  the  patient's 
mind  off  himself  and  his  talking.  It  was  long  ago  observed 
that  patients  seldom  or  never  stutter  when  they  sing,  and 
that  the  stutterer  has  a  tendency  to  try  to  talk  on  empty 
lungs. 

Many  forms  of  physical  tremors  that  are  not  associated 
with  real  disease  also  belong  to  this  same  group  of  nervous 
disorders. 

MIGRAINE NERVOUS  SICK-HEADACHE 

Last,  but  not  least,  among  the  inherited  nervous  disorders, 
should  be  mentioned  the  periodic  nervous  headache  —  mi- 
graine. The  disease  is  just  as  certainly  hereditary  as  epi- 


ARE  WE  BECOMING  A  NEUROTIC  RACE?         209 

lepsy,  perhaps  more  so.  It  is,  from  the  standpoint  of  medi- 
cal science,  an  incurable  form  of  headache,  though  much  can 
be  done  to  help  these  sufferers.  When  both  parents  have 
these  headaches,  the  children  are  almost  sure  to  be  sufferers, 
but  when  only  one  parent  is  afflicted,  the  majority  of  the  off- 
spring is  apt  to  be  free  from  it.  If  one  parent  is  entirely 
free  from  the  disorder  and  comes  from  a  family  likewise 
unaffected,  then  none  of  the  children  are  likely  to  be  affected. 
Mendel's  law  of  heredity  appears  to  govern  in  the  case  of 
this  disorder. 

And  so  it  would  seem  that  almost  all  of  these  nervous  dis- 
orders which  afflict  the  white  race  are  on  the  increase 
throughout  the  civilized  world,  and  the  author  believes  partic- 
ularly on  the  increase  when  it  comes  to  the  American  people. 
But  the  problem  would  be  far  from  serious  if  this  were  all 
we^had  to  fear  regarding  the  increase  of  hereditary  nervous 
diseases.  This  is  but  an  introduction.  These  disorders  are 
indeed  minor  and  trivial  compared  to  the  more  serious  nerv- 
ous diseases  and  mental  disturbances  which  we  are  about  to 
consider. 

SUMMARY  OF  THE  CHAPTER 

1.  There  is,  undoubtedly,  an  increase  in  general  nervous- 
ness ;  caused  more  by  heredity  than  by  environment. 

2.  This  nervous  group  embraces  those  with  chronic  worry, 
special  fears,  definite  dreads,  obsessions,  the  hyper-consci- 
entious, and  those  who  take  everything  too  seriously,  in- 
cluding themselves. 

3.  These  nervous  sufferers  make  a  combined  religion  and 
business  of  being  sick,  of  spying  on  themselves  and  thinking 
incessantly  of  their  disagreeable  feelings  and  sensations. 

4.  Neurasthenia  is  on  the  increase,  due  to  deterioration  in 
the  nervous  fiber.    More  and  more  people  are  born  neurologi- 
cally  bankrupt. 

5.  Neurasthenia  is  not  a  disease;  it  is  a  state  of  habitual 


210  RACE  DECADENCE 

nervous  fatigue  —  a  functional  nervous  disorder  due  largely 
to  heredity,  but  also  influenced  by  environment. 

6.  The  minor  symptoms  of   neurasthenia   may   embrace 
headache,  backache,  insomnia,  dyspepsia,  constipation,  and  a 
host  of  sensory  disturbances  such  as  itching,  crawling,  prick- 
ing, etc. 

7.  The  characteristic  earmarks  of  the  neurasthenic  state 
are :  increased  suggestibility,  oversensitiveness,  abnormal  im- 
pressibility, and  increased  emotionalism. 

8.  In  neurasthenia,  decision  is  hampered  and  delayed.    Pa- 
tients find  it  very  difficult  to  "  make  up  their  minds." 

9.  There  is  much  fastidious  pain  and  imaginary  suffering ; 
and,  while  an  imaginary  disease  may  not  be  real,  a  diseased 
imagination  is  one  of  the  realest  things  in  the  world. 

10.  There  is  grave  danger  of  neurasthenics   forming  a 
habit  of  suffering  and  complaining  and  this  may  be  carried 
to  the  point  of  apparently  "  enjoying  poor  health." 

11.  The  psychasthenes  are  those  who  suffer  from  inherited 
neurasthenia  —  true  brain-fag.     They  are  the  unfortunates 
who  are  "  born  tired." 

12.  In  simple  surroundings  many  psychasthenes  do  well; 
but  in  the  large  city  they  are  apt  to  break  down,   "  go 
wrong,"  or  "  blow  up." 

13.  The  chief  troubles  of  the  psychasthenes  are:  ever- 
present  weariness,  incapacity  for  work,  and  in-growing  of 
the  attention  —  they  can't  get  their  minds  off  themselves. 

14.  The  psychasthenes  —  in  common  with  neurasthenes, 
make  a  business  of  "  spying  "  on  themselves. 

15.  Mental  training,  re-educating  the  will,  and  developing 
the  power  of  decision  will  work  curative  wonders  for  all 
these  neurotic  sufferers. 

1 6.  Hysteria  as  a  disease  is  one  thing  and  hysterics  —  in 
which  any  nervous  person  may  indulge  —  is  quite  another 
thing. 

17.  Hysteria  is  a  sort  of  hereditary  deficiency  in  nerve- 
control —  a  mild  disorder  of  personality  in  certain  highly 
suggestible  and  overemotional  individuals. 

18.  In  hysteria  the  sympathetic  nervous  system  seems  to 
indulge  in  wild,  runaway  performances  at  the  behest  of  an 
uncontrolled  imagination. 


ARE  WE  BECOMING  A  NEUROTIC  RACE?         211 

19.  The  characteristics  of  hysteria  are:  lack  of  control 
over  certain  physical  acts,  emotional  explosions,  morbid  self- 
consciousness,  sensory  exaggerations,  together  with  a  pecul- 
iar ability  to  impersonate  numerous  other  diseases. 

20.  Hysteria  is  a  hereditary  disorder.    It  is  transmitted  to 
succeeding  generations,  modified  by  the  nervous  character  of 
the  other  parent  concerned. 

21.  There  is  some  ground  for  the  belief  that  these  func- 
tional nervous  disorders,  unlike  insanity,  show  a  tendency  to 
"  breed  out  "  of  the  stock  in  successive  generations. 

22.  The  symptoms  of  hysteria  are  too  many  and  varied 
to  summarize ;  and  too  well  known  to  require  naming. 

23.  Racial  instability,  lack  of  self-poise  and  self-control, 
are  hereditary  and  their  increase  in  the  nation  is  not  to  be 
viewed  with  equanimity. 

24.  Hypochondriacs    are   those    who    suffer    from    both 
physical  and  mental  ailments ;  they  make  a  business  of  being 
sick  even  when  they  are  well. 

2$.  Chorea,  together  with  a  host  of  nervous  "  tics  "  are 
merely  straws  which  show  which  way  the  winds  of  heredity 
are  blowing. 

26.  Stuttering  and  stammering  are  only  other  manifesta- 
tions of  this  inherited  nervous  instability  and  are  cured  by 
any  system  that  gets  the  patient's  mind  off  himself  and  his 
defect. 

27.  Migraine  —  nervous  sick  headache  —  is  an  inherited 
disorder  which  unerringly  passes  on  from  one  generation 
to  another,  almost  in  accord  with  Mendel's  law. 


CHAPTER  XV 
IS  INSANITY  INCREASING? 

THE  word  insanity  means  little  or  nothing  from  a  scien- 
tific viewpoint,  as  it  is  so  loosely  used  to  describe  all 
sorts  of  mental  and  nervous  ailments.  No  difference  is  gen- 
erally made  in  the  mind  of  the  public  between  a  man  who  has 
gone  insane  following  the  toxemia  of  a  severe  case  of  typhoid 
fever  or  meningitis  and  a  woman  who  has  "  gone  crazy  " 
following  some  simple  nervous  strain,  because  of  the  fact 
that  she  was  born  of  defective  ancestors  —  because  she 
literally  inherited  insanity  —  and,  in  her  turn,  if  she  is  per- 
mitted to  —  will  just  as  certainly  transmit  the  cursed  strain 
of  defect! veness  on  down  the  line  to  the  next  and  succeeding 
generations. 

It  is  in  this  latter  sense,  the  sense  of  hereditary  insanity, 
that  the  term  is  more  largely  used  in  this  chapter.  We 
have  little  to  fear  from  increased  insanity  due  to  vice, 
intemperance,  and  disease  —  we  know  the  cause  —  and  can 
apply  the  remedies  any  time. 

INSANITY  IN  THE  UNITED  STATES 

The  total  number  of  institutions  for  the  insane  canvassed 
at  the  last  special  census  was  366,  and  the  total  number  of 
insane  for  whom  data  were  obtained  was  248,560,  of  whom 
187,791  were  present  in  the  institutions  on  January  I,  and 
60,769  were  admitted  during  the  year.  The  number  of  insane 
enumerated  in  institutions  at  the  census  of  1904  was  199,773. 
including  150,151  inmates  present  at  the  beginning  of  the 
year  and  49,622  admitted  during  the  year.  In  the  six  years 

212 


75"  INSANITY  INCREASING?  213 

from  1904  to  1910  there  was  an  increase  of  37,640,  or  25.1 
per  cent,  in  the  number  of  insane  confined  in  institutions  for 
that  class,  as  compared  with  an  increase  of  only  about  12 
per  cent  in  the  total  population  of  the  United  States,  the  num- 
ber of  insane  in  hospitals  per  100,000  population  advancing 
from  183.6  in  1904  to  204.2  in  1910.  The  increase  during 
this  period  in  the  number  admitted  to  such  institutions  dur- 
ing the  year  was  11,147,  or  22-5  Per  cent>  the  ratio  of  admis- 
sion per  100,000  population  increasing  from  60.7  in  1904 
to  66.1  in  1910.  As  no  attempt  was  made,  either  in  1904 
or  in  1910,  to  enumerate  the  insane  outside  of  institutions, 
it  is  a  question  to  what  extent  this  striking  increase  in  the 
population  of  hospitals  for  the  insane  and  in  the  number 
of  annual  commitments  to  such  institutions,  represents  an 
increase  in  the  prevalence  of  insanity,  and  to  what  extent 
it  tnay  be  due  to  an  extension  of  the  practice  of  placing 
the  insane  under  institutional  care.  This  is  a  question  which 
will  receive  some  consideration  in  the  discussion  which  fol- 
lows. Appendix  A,  Table  No.  5,  shows  the  institutional 
insane  in  the  United  States  from  1850  to  1910. 

INSANITY    IN    GREAT    BRITAIN 

The  increase  of  insanity  in  Great  Britain  is  cited  by 
Doctor  Tredgold  as  evidence  of  race  degeneracy.  While  the 
increase  of  the  population  of  England  and  Wales  in  fifty- 
two  years  has  been  85.5  per  cent,  the  increase  of  the  certified 
insane  has  been  262.2  per  cent.  At  the  present  time  there 
is  one  insane  person  to  every  275  of  the  normal  population 
of  England  and  Wales.  This  fact  is,  to  say  the  least, 
"  very  disquieting."  But,  as  the  Doctor  still  further  shows, 
"  there  is  even  a  more  numerous  class  suffering  from  a  still 
more  serious  condition  inasmuch  as  their  incapacity  is  not 
possibly  temporary,  but  is  permanent  and  incurable. 
These  are  the  feeble-minded." 


214  RACE  DECADENCE 

Of  this  class,  there  is  now  known  to  be  in  England  not 
fewer  than  150,000,  making  a  total  of  290,000  mentally 
affected  persons  in  England  and  Wales,  besides  "  a  vast 
horde  of  persons  discharged  from  asylums,  whose  mental 
condition  is  decidedly  unsatisfactory ;  and  an  additional  army 
of  individuals,  who,  although  they  have  not  yet  been 
committed  to  asylums,  are  nevertheless  of  feeble  and  un- 
stable mental  constitution  and  may  well  be  described  as 
potential  lunatics."  Dr.  Tredgold  makes  the  remarkable 
statement  that  in  England  and  Wales  the  mentally  infirm 
constitute  "  well  over  i  per  cent  "of  the  entire  community. 

Table  No.  6,  Appendix  A,  shows  the  findings  of  the 
Census  Bureau  in  regard  to  the  number  of  insane  of  various 
ages  in  the  United  States,  and  indicates  that  the  highest  per 
cent  was  from  55  to  59  years  —  587.8  per  100,000  of  popula- 
tion. The  total  number  of  insane  of  all  ages,  according  to 
this  table,  represents  204.2  per  100,000  of  population. 

STATISTICS   ON   INSANITY 

One  authority  estimates  that  we  have  one  insane  person 
in  the  United  States  for  every  280  population.  We  actually 
have  one  insane  person  in  our  state  institutions  for  about 
every  350  population.  No  one  knows  what  per  cent  of  our 
insane  is  confined  in  public  institutions. 

The  statistics  throughout  the  whole  country  seem  to  indi- 
cate that  insanity  is  increasing  two  or  three  times  faster  than 
the  population  —  certainly  not  less  than  twice  as  fast.  The 
following  table  shows  the  alarming  increase  in  the  percentage 
of  insanity  since  1850  in  this  country  and  Great  Britain. 

UNITED  STATES 

1850  —  insane  persons  to  1,000,000  population 673 

1900  —  insane  persons  to  1,000,000  population....  1,700 
1910  —  insane  persons  to  1,000,000  population 2,042 


IS  INSANITY  INCREASING?  215 

GREAT  BRITAIN 

1850 — insane  persons  to  1,000,000  population 1,810 

1900  —  insane  persons  to  1,000,000  population 3,070 

By  studying  these  statistics  we  see  where  our  friends 
who  believe  we  are  a  passing  race  get  their  alarming  ideas ; 
for,  worked  out  (as  one  pessimist  sees  things)  it  looks  on 
paper  something  like  this : 

At  same  ratio  of  increase : 

Per 
Cent 

1950  we  have  insane  persons  per  1,000,000  of  population  3400 
2000  we  have  insane  persons  per  1,000,000  of  population  10,000  i 
2050  we  have  insane  persons  per  1,000,000  of  population  30,000  3 
2100  we  have  insane  persons  per  1,000,000  of  population  90,000  g 
2150  we  have  insane  persons  per  1,000,000  of  population  270,000  27 
2200  we  have  insane  persons  per  1,000,000  of  population  810,000  81 
Before  2250  the  total  population  will  be  insane 100 

The  error  in  these  statistics  and  figures  will  be  more 
fully  discussed  presently.  The  truth  is  bad  enough  —  there 
is  no  occasion  for  magnifying  the  serious  state  of  affairs. 

In  Chicago,  Dr.  Podstata,  once  estimated  that  one  person 
in  every  150  was  insane  or  mentally  unbalanced;  while  one 
person  in  every  5  was  thought  to  be  more  or  less  predisposed 
to  insanity.  The  following  estimates  were  made  of  conditions 
in  the  state  of  Illinois : 

15,000  insane  10,000  epileptics 

54,000  unstable  10,000  imbeciles 

Stated  in  percentage: 

Total  population  5,000,000 

Total   defectives    35,ooo 

This  would  mean  that  we  had  7,000  defectives  to  1,000,000 
of  population  and  this  is  about  I  per  cent.  If  this  is  true 
we  are  in  about  as  bad  a  condition  as  they  are  in  England. 

This  same  tendency  to  insanity  may  explain  why  there 


2l6  RACE  DECADENCE 

are  10,000,000  persons  living  in  comparative  poverty  in  the 
United  States,  and  also  why  this  land  of  plenty  and  pros- 
perity should  boast  of  over  4,000,000  actual  paupers  and 
dependents. 

Dr.  C.  L.  Dana,  formerly  president  of  the  New  York 
Academy  of  Medicine,  believes  the  increase  in  insanity  to 
be  real  as  well  as  apparent.  He  says :  "  The  annual  incre- 
ment of  insane  in  Massachusetts,  according  to  the  Massa- 
chusetts Board  of  Lunacy  is  400  in  about  10,000  or  4  per 
cent."  At  this  ratio  the  annual  increment  for  the  United 
States  would  be  approximately  5,600. 

We  may  say  that  in  tne  iast  twenty-five  years  the  ratio  of  insane 
to  sane  has  shown  an  apparent  gradual  increase  from  i  to  450  to 
I  to  300,  and  this  latter  seems  to  be  about  the  ratio  in  those  com- 
munities of  North  America  and  Europe  in  which  modern  conditions 
of  civilization  prevail.  This  average  has  varied  but  little  in  the  last 
few  years :  the  slight  yearly  increase  probably  will  not  change  rapidly 
and  probably  not  continue,  for  when  the  increase  in  the  insane 
reaches  a  certain  point  of  excess,  society  will  have  to  take  notice  of 
it  and  correct  it. 

There  are  no  accurate  figures  of  the  total  number  of  insane. 
Mr.  Sanborn  estimates  that  the  number  exceeds  250,000  in 
the  United  States.  Our  reliable  data  pertains  only  to  those 
insane  persons  who  are  confined  in  public  institutions.  No 
one  knows  the  number  of  those  who  are  at  large,  or  con- 
fined in  special  and  private  institutions.  As  has  already 
been  noted  the  total  number  of  insane  in  state  institutions 
at  the  last  special  census  was  187,791  with  60,769  admitted 
during  the  year. 

But  when  all  is  said  and  done,  the  fact  remains  that  there 
are  several  hundred  thousand  insane  persons  in  the 
United  States  (not  to  mention  tens  of  thousands  of  feeble- 
minded and  other  defectives)  many  of  whom  are  not  pre- 
vented from  reproducing  their  kind,  and  that  by  this  failure 
to  restrain  them,  present-day  society  is  putting  a  heavy  bur- 


75-  INSANITY  INCREASING?  217 

den  of  expense,  unhappiness,  and  a  fearful  racial  handicap 
on  coming  generations. 

ANALYSIS  OF  INSANITY  STATISTICS 

.After  due  allowance  has  been  made,  however,  for  those 
factors  which  affect  the  ratio  of  institutional  insane  to  total 
population,  and  yet  have  nothing  to  do  with  the  relative 
number  of  cases  of  insanity  in  the  community,  it  is  never- 
theless reasonably  certain  that  the  rates  are  also  affected 
by  actual  differences  in  the  prevalence  of  insanity  in  dif- 
ferent sections  of  the  United  States.  Such  differences  nat- 
urally result  from  variations  in  the  composition  of  the 
population  as  regards  sex,  color,  race,  nativity,  and  age,  and 
to  an  even  greater  extent  probably  from  variations  in  the 
proportion  of  the  population  living  in  cities  or  engaged  in 
industrial  or  commercial,  as  distinguished  from  agricultural 
pursuits. 

The  migration  of  the  native  population  within  the  United 
States  doubtless  has  some  effect  upon  the  prevalence  of 
insanity  in  the  different  sections.  The  defectives  and 
subnormals  do  not  usually  emigrate.  They  are  left  behind 
in  the  older  sections  of  the  country  while  the  newer  sections 
are  being  settled  by  the  more  vigorous  and  energetic  repre- 
sentatives of  the  native  stock.  How  insanity  varies  in  dif- 
ferent sections  of  the  United  States,  is  shown  in  Table  No. 
7,  Appendix  A. 

CONDITIONS   LEADING   TO    INCREASE   OF   INSANITY 

The  ratio  of  total  insanity  enumerated  in  1880,  when  the 
enumeration  is  believed  to  have  been  more  complete  than  at 
any  other  census,  was  183.3  per  100,000  of  the  total  popula- 
tion. In  1910  the  insane  in  hospitals  alone  represented  a 
ratio  of  204.3  Per  100,000  population.  As  compared  with 
the  total  population,  therefore,  the  number  of  insane  in  in- 


160 


140 


120 


no 


100 


160 


140 


120 


110 


100 


Fig.  12.  Graphic  showing  increase  in  insanity  in  the 
United  States.  Figures  indicate  number  of  insane  per  100,000 
of  population 


IS  INSANITY  INCREASING?  219 

stitutions  in  1910  was  relatively  greater  than  the  total  num- 
ber of  insane  enumerated  in  1880.     (See  Fig.  12.) 

Without  entering  into  any  general  discussion  of  the  causes 
or  influences  which  might  be  operative  in  promoting  an 
increase  of  insanity,  one  important  change  in  social  condi- 
tions in  the  United  States  as  revealed  by  census  statistics 
may  be  noted  in  this  connection,  namely,  the  great  increase 
in  the  proportion  of  population  living  in  cities.  In  the  thirty 
years  between  1880  and  1910  the  urban  population  of  the 
United  States  —  that  is  the  population  residing  in  incor- 
porated places  having  more  than  2,500  inhabitants,  including 
New  England  towns  above  that  limit  —  increased  about  190 
per  cent,  or  from  15,000,000  in  1880  to  43,000,000  in  1910, 
while  the  rural  population  increased  only  about  40  per 
cent,  or  from  35,000,000  in  1880  to  49,000,000  in  1910. 
In  1880,  29.5  per  cent  of  the  population  was  urban,  and  in 
1910,  46.3  per  cent,  in  1921  more  than  half  of  our  people 
live  in  cities.  It  may  be  remarked  that  many  of  the  smaller 
places  classed  as  urban  communities  are  far  from  being 
distinctly  urban  in  their  characteristics;  but  there  has  been 
at  the  same  time  a  marked  growth  and  concentration  of 
population  in  large  cities.  Thus  the  number  of  cities  of  over 
100,000  population  increased  from  20  in  1880  to  50  in  1910, 
and  the  aggregate  population  living  in  such  cities  from 
6,000,000  to  20,000,000,  an  increase  of  over  200  per  cent. 
The  proportion  of  the  total  population  living  in  cities  of  this 
class  in  1880  was  12.4  per  cent,  or  about  one-eighth,  as  com- 
pared with  22.1  per  cent,  or  more  than  one-fifth,  in  1910. 
If,  as  is  indicated  by  statistics  presented  later,  insanity  is 
more  prevalent  in  urban  than  in  rural  communities,  some 
increase  of  insanity  would  seem  to  be  an  almost  inevitable 
result  of  the  increasing  urbanization  of  the  population  of  the 
United  States.  It  should  be  made  plain  that  city  life  —  in 
and  of  itself  — does  not  directly  lead  to  an  increase  in 


220  RACE  DECADENCE 

insanity.  These  statistics  are  rather  to  be  explained  by  the 
fact  that  the  stress  and  strain  of  the  larger  centers  of  popula- 
tion serve  to  develop  and  bring  to  the  surface  those  cases 
of  latent  and  hereditary  insanity. 

The  extension  of  the  practice  of  placing  the  insane  under 
institutional  care  has  also  had  a  very  great  influence  upon 
the  statistics.  Associated  with  this  are  other  influences 
which  have  likewise  contributed  to  the  apparent  increase  of 
insanity,  or  to  the  increase  in  the  number  of  recognized 
and  recorded  cases,  without  being  indicative  of  any  great 
actual  increase.  Among  these  may  be  mentioned :  increasing 
average  length  of  life,  bringing  more  people  to  the  "  in- 
sanity age  periods ;"  advances  in  diagnostic  methods  of 
psychiatry,  leading  to  the  detection  of  mental  factors  in 
physical  cases ;  the  establishment  of  dispensaries ;  the  provi- 
sion of  "  voluntary  "  and  emergency  commitment ;  and  bet- 
ter means  of  transportation  (the  automobile  for  instance), 
making  it  possible  to  bring  to  the  hospital  cases  in  poor 
physical  condition. 

So  far  as  an  increase  of  insanity  is  associated  with  the 
growth  of  cities  it  may  be  said  that  it  probably  results  to  a 
large  extent  from  causes  which  are  preventable  or  subject 
to  control.  Statistics  indicate  that  the  difference  between 
city  and  country  as  regards  the  prevalence  of  insanity  is 
partly  accounted  for  by  the  greater  number  of  cases  of  gen- 
eral paralysis  and  alcoholic  psychosis  in  the  urban  population. 
This  in  itself  is  a  significant  fact  because  these  are  diseases 
the  causes  of  which  must  be  regarded  as  preventable  or  con- 
trollable; and  the  better-organized  work  in  preventive  medi- 
cine, in  social  service,  and  in  hospital  and  dispensary  relief, 
makes  the  outlook  for  prevention  in  any  disease  more 
encouraging  in  cities  than  in  rural  communities.  Interest  in 
the  possibility  of  controlling  some  of  the  causes  of  mental 
disease  has  developed  only  very  recently,  and  it  is  not  too 


IS  INSANITY  INCREASING?  221 

much  to  hope  that  considerable  progress  in  that  direction 
may  be  achieved  in  the  near  future. 

INSANITY'S  THREAT 

A  medical  friend  not  long  ago  called  my  attention  to  the 
statistics  already  noted  —  to  the  deduction  that  the  whole 
population  was  threatened  with  becoming  insane  in  a  few 
hundred  years  —  that  insanity  appeared  to  be  increasing  al- 
most three  hundred  times  faster  than  the  population  of  the 
country.  He  was  alarmed  over  the  prospects.  These 
statistics  all  seem  to  be  reliable  and  up-to-date.  These  figures 
and  calculations  seem  to  show  conclusively  that  in  just 
330  years  every  man,  woman,  and  child  in  this  country  will 
be  a  raving  maniac  —  there  would  not  even  be  enough  sane 
persons  left  to  take  care  of  the  lunatics  —  the  whole  coun- 
try would  have  become  one  vast  crazy  house. 

What  is  wrong  with  those  statistics?  Surely,  there  is 
a  mistake  somewhere ;  for,  no  matter  how  bad  the  situation 
may  be  —  it  cannot  be  that  serious.  There  is  nothing  wrong 
with  the  statistics  —  they  are  authentic  and  reliable.  There 
is  no  doubt,  also,  that  insanity  has  been  tremendously  on  the 
increase  during  the  last  few  generations  in  both  this  coun- 
try and  Great  Britain.  The  trouble  with  my  friend's  con- 
clusions and  the  statistics  on  insanity  consists  in  the  over- 
looking of  two  vital  points  when  it  comes  to  the  interpreta- 
tion of  figures  on  insanity,  and  these  two  points  are: 

1.  We  are  keeping  better  books  than  we  used  to.     We 
are  getting  a  more  complete  record  of  the  insane,  and  more 
of  these  unfortunates  are  year  by  year  being  gathered  to- 
gether in  public  institutions.     Things  may  not  be  so  much 
worse  than  they  were  in  the  recent  past  —  we  are  simply 
waking  up  to  a  recognition  of  the  facts. 

2.  We  now  classify  the  insane  differently  than  heretofore. 
A  lot  of  folk  that  used  to  be  regarded  as  merely  being  a 


222  RACE  DECADENCE 

little   "  peculiar  "   are  now   put   down  as   "  insane  " —  and 
that  makes  our  statistics  look  still  worse. 

Let  us  be  frank  and  sincere  with  ourselves.  There  is  no 
need  of  making  the  thing  out  worse  than  it  is  —  it  is  bad 
enough  at  best.  Even  when  we  have  discounted  the  statis- 
tics and  made  every  reasonable  allowance,  as  just  sug- 
gested, still  we  must  face  the  stern  fact  that  insanity  is 
steadily  gaining  on  us  —  it  constitutes  a  real  menace  —  it 
will  jeopardize  the  nation  if  nothing  is  done  in  the  near 
future  to  lessen  its  rate  of  increase  among  the  American 
people. 

INSANITY    AND    HEREDITY 

The  author  maintains  that  insanity  is  largely  hereditary  — 
with  the  exception  of  those  cases  caused  by  certain  diseases 
and  injuries.  Syphilis,  alcohol,  drugs,  typhoid  fever,  and 
certain  other  diseases,  may  produce  insanity,  by  causing 
brain  tumors,  diseases,  etc.,  but  the  vast  majority  of  the 
insane  —  those  who  "  go  crazy  "  from  the  results  of  love 
affairs,  domestic  trouble,  business  worries,  religion  —  even 
drink  —  were  born  into  this  world  with  a  through  ticket  to 
the  insane  asylum,  and  all  they  needed  to  cut  short  their 
stop-over  on  the  outside  was  some  sort  of  stress  or  strain 
which  would  serve  to  develop  their  latent  and  inherited 
tendency  to  "  go  to  pieces  "  or  "  blow  up." 

Various  authorities  estimate  heredity  as  responsible  for 
from  35  per  cent  to  75  per  cent  of  the  insanities  —  and  the 
author  is  firmly  convinced  that  inherited  insanity  is  respon- 
sible for  a  full  half,  if  not  more,  of  those  who  now  fill  our 
hospitals  for  the  insane  to  overflowing. 

Two  types  of  insanity  are  now  recognized  as  being  espe- 
cially transmissible  by  heredity,  viz.,  dementia  praecox,  a 
sort  of  precocious  old  age,  in  which  the  patient  (generally 
young),  sinks  into  a  lethargy  from  which  he  rarely  pertna- 


75*  INSANITY  INCREASING?  223 

nently  recovers;  and  maniac-depressive  insanity,  an  over- 
excitable  condition  in  which  there  are  occasional  very  erratic 
motor  discharges,  alternating  with  periods  of  depression. 
"  Constitutional  psychopathic  inferiority,  which  means  a  lack 
of  emotional  adaptability,  usually  shows  in  the  family  his- 
tory," of  these  cases.  The  common  type  of  insanity  which 
is  characterized  by  mild  hallucinations  is  of  less  concern 
from  a  eugenic  point  of  view. 

In  general,  the  present  isolation  of  the  sexes  at  institu- 
tions for  the  insane  is  fairly  satisfactory;  the  principal 
problem  which  insanity  presents  lies  in  the  fact  that  an  in- 
dividual is  frequently  committed  to  a  hospital  or  asylum, 
kept  there  a  few  years  until  apparently  cured,  and  then  dis- 
charged; whereupon  he  returns  to  his  family  to  beget  off- 
spring that  are  fairly  certain  to  become  insane  at  some 
peaod  in  their  after  lives. 

NON-HEREDITARY  INSANITIES 

How  much  insanity  is  due  to  hereditary  defects  in  the 
germ-plasm  and  how  much  is  due  to  disease  and  other  causes  ? 
The  inquiries  of  the  Census  Bureau  would  indicate  that 
almost  17  per  cent  of  the  insane  admitted  annually  to  our 
state  institutions  are  caused  by  general  alcoholic  paralysis 
or  alcoholic  psychoses.  One-sixth  of  our  insanity  would 
thus  appear  to  be  directly  or  indirectly  alcoholic  in  origin. 

The  author  believes  that  syphilis  must  be  responsible  for 
quite  as  much  insanity  (about  16  per  cent)  as  is  alcohol;  in 
fact,  he  believes  that  some  of  the  cases  charged  up  to  alcohol 
may  be  more  or  less  due  to  syphilis.  No  doubt  some  cases 
are  caused  by  both  alcohol  and  syphilis.  Suppose  we  allow 
that  all  other  causes  of  insanity  —  including  disease,  tumors, 
accidents,  etc.,  embrace  an  equal  number,  about  16  per  cent. 
This  would  suggest  that  one-sixth  of  our  insanity  was  due 
to  alcohol  and  drugs:  one-sixth  due  to  syphilis  and  its  re- 


224  RACE  DECADENCE 

sultant  paresis ;  and  one-sixth  due  to  sundry  other  causes  — 
leaving  the  balance  of  50  per  cent  as  due  to  heredity  —  in- 
herent defects  in  the  constitution  of  the  germ-plasm  of  the 
parents  of  these  unfortunate  individuals. 

MARRIAGE  LAWS  RELATING  TO  THE  INSANE 

The  laxity  of  our  marriage  laws  regarding  the  insane  or 
those  tainted  individuals  who  are  predisposed  to  insanity  is 
indicated  by  the  fact  that  about  one-third  of  the  present-day 
inmates  of  insane  asylums  are  married.  No  doubt  the  vast 
majority  of  these  married  have  one  or  more  children,  who 
bear  their  taint  —  that  is,  in  the  case  of  at  least  50  per  cent  of 
our  insane,  whose  ailment  is  largely  hereditary. 

The  large  percentage  of  single  persons  among  the  insane 
is  not  to  be  interpreted  as  indicating  that  the  single  are  more 
liable  to  become  insane  than  the  married.  It  means  rather 
that  the  insane,  as  compared  with  the  normal,  are  less  likely 
to  marry.  Some  forms  of  insanity  unfailingly  act  as  a  natural 
barrier  to  marriage.  Moreover,  in  most  states  the  marriage 
of  a  known  insane  person  is  prohibited  by  law,  and  the  prob- 
ability is  that  most  of  the  insane  who  have  been  married  were 
married  before  insanity  outwardly  developed. 

Our  marriage  laws  are  much  more  effective  as  regards  in- 
sanity than  they  are  concerning  feeble-mindedness.  The 
great  need  of  improvement  lies  along  the  lines  of  curtailing 
the  mating  of  those  dangerous  and  defective  individuals 
who  appear  to  be  fairly  normal  on  the  surface,  but  who  are 
the  carriers  of  the  deadly  strains  of  racial  degeneracy. 

"  GOING  INSANE  " 

How  prone  we  are  to  overlook  the  hereditary  side  of 
insanity!  We  explain  that  Mr.  A.  has  gone  insane  from 
worry,  business  losses,  or  overwork.  Yet  thousands  worry, 
suffer  great  losses,  and  work  hard,  and  yet  show  no  signs 


IS  INSANITY  INCREASING?  22$ 

of  nervous  breakdown.  It  would  be  more  correct  to  say 
that  so-and-so  went  insane  because  his  brain  and  nervous 
system  were  not  strong  enough  to  stand  the  stresses  to  which 
they  were  subjected.  As  a  matter  of  fact,  insanity  seldom  or 
never  occurs  except  where  the  germ-plasm  is  defective; 
unless  there  is  present  syphilis  or  some  other  definite  disease 
to  explain  the  catastrophe.  Also  epilepsy,  which  is  so  often 
ascribed  to  external  conditions,  is,  like  imbecility,  determined 
chiefly  by  the  condition  of  the  germ-plasm;  and  the  trivial 
circumstances  that  first  reveal  these  defects  are  no  more  the 
real  and  fundamental  cause  of  these  mental  upheavals,  than 
the  touching  of  the  electric  button  that  opens  an  exposition 
is  the  motive  power  that  propels  its  vast  engines.  "  Father," 
says  the  young  hopeful,  "  may  I  go  skating?  "  "  So  far  as  I 
am  concerned ;  but  you  had  better  ask  your  mother,"  replies 
the*  father.  "  No,  indeed,"  puts  in  the  mother,  "  for  I  read  in 
the  paper  the  other  day  of  a  boy  who  fell  on  the  ice  and  had 
an  epileptic  fit."  Thus  does  the  untrained  mind  confuse  con- 
tributing and  essential  causes.  The  same  is  also  true  of 
those  women  who  are  supposed  to  have  "  lost  their  minds  " 
during  the  change  of  life.  Women  of  sound  heredity  do 
not  "  go  crazy  "  as  a  result  of  menopause. 

We  read  that  a  certain  prominent  citizen  has  had  a  "  nerv- 
ous breakdown"  —  that  he  has  gone  to  California  for  a 
long  rest  from  business  cares  and  other  harassments.  Next 
we  read  that  this  same  prominent  citizen  has  "  gone  crazy  " 
or  committed  suicide,  and  immediately  ten  thousand  neurotic 
and  nervous  individuals  are  seized  with  the  terrible  fear  that 
they  also  will  either  commit  suicide  or  "  go  crazy."  Whereas, 
there  is  little  or  no  danger  that  either  of  these  things  will 
happen  to  simple  neurotics  who  do  not  have  a  "  streak  of 
insanity  running  in  the  family." 

People  who  "  go  insane  "  in  the  absence  of  any  specific 
or  organic  disease  of  the  brain,  are  born  with  the  tendency  — 


226  RACE  DECADENCE 

they  are  doomed  by  heredity  —  they  are  the  descendants  of 
defective  stock  —  they  were  mentally  insolvent  and  biologi- 
cally bankrupt  when  they  were  born  into  the  world. 

RECURRENT  INSANITY 

While  it  is  true  that  many  persons  are  discharged  from 
hospitals  for  the  insane  as  cured  or  improved,  it  is  also 
true  that  many  of  them  return  later  with  a  recurrence  of 
their  mental  troubles  —  simply  because  insanity  is  a  part 
of  their  nature  —  it  is  inherent  in  them. 

Of  the  60,769  persons  admitted  to  hospitals  for  the  insane 
in  1910,  40,130,  or  65  per  cent,  were  reported  as  first 
admissions,  and  13,914,  or  23  per  cent,  were  reported  as 
having  been  previously  in  hospitals  for  the  insane;  while  in 
the  case  of  6,715,  or  n.i  per  cent  of  the  total  number,  no 
information  covering  this  question  was  obtained.  The  num- 
ber of  persons  who  had  been  previously  admitted  represents 
about  26  per  cent  of  the  total  number  for  which  the  facts 
as  to  previous  admissions  were  ascertained.  The  figures 
indicate,  therefore,  that  somewhat  more  than  one-fourth  of 
the  persons  admitted  to  hospitals  for  the  insane  are  recurrent 
cases.  In  some  cases  they  had  been  in  an  institution  for  the 
insane  as  many  as  five  times  or  more;  many  having  been 
committed  from  two  to  four  times.  In  some  forms  of  insan- 
ity—  the  serious  and  hereditary  forms  —  it  seems  to  work 
out  "  once  insane,  always  insane,"  more  or  less. 

The  number  of  persons  discharged  from  hospitals  for  the 
insane  in  the  year  1910  was  29,304.  Of  these  24,241,  or  82.7 
per  cent,  were  discharged  as  either  improved  or  recovered; 
4,397,  or  15  per  cent,  as  unimproved;  and  491,  or  1.7  per 
cent,  as  not  insane.  No  attempt  was  made  to  distinguish 
the  "  recovered  "  from  the  "  improved."  The  reasons  why 
this  was  not  done  are  stated  by  the  Census  Bureau  as  fol- 
lows : 


75"  INSANITY  INCREASING?  22? 

There  is  no  standard  definition  of  what  constitutes  recovery  from 
insanity.  Some  officials  class  as  such  all  who  show  betterment,  while 
others  are  very  chary  in  describing  their  patients  as  having  fully 
recovered.  In  consequence  the  percentages  of  recoveries  reported 
from  different  institutions  vary  in  an  astounding  degree.  It  there- 
fore seemed  wiser  to  group  all  recoveries  under  the  heading  "im- 
proved" and  avoid  the  presentation  of  figures  that  could  not  be 
explained  and  therefore  might  lead  to  wholly  unfair  comparisons. 

Think  of  the  fact  that  almost  5,000  insane  persons  (15 
per  cent  of  the  total  number  discharged)  are  annually  turned 
loose  on  the  public  "  unimproved."  These  irresponsible 
beings,  if  their  age  is  suitable,  are  in  many  instances  free 
to  marry  if  opportunity  offers  itself,  or  otherwise  to  become 
responsible  for  bringing  into  this  world  other  beings  cursed 
with  these  same  mental  deficiencies. 

Of  the  more  than  80  per  cent  (about  25,000  annually) 
who  are  discharged  from  asylums  as  "  improved  "  or  "  re- 
covtsred,"  we  know  that  not  less  than  25  per  cent  will  find 
their  way  back  into  public  institutions  for  the  care  of  the 
insane,  anywhere  from  two  to  five  times  before  they  die  — 
in  the  meantime  having  contributed  numerous  legitimate  or 
illegitimate  offspring  to  curse  the  coming  generations. 

INSANITY  AMONG  IMMIGRANTS 

Of  the  total  number  of  inmates  of  insane  asylums  on 
January  i,  1910,  28.8  per  cent  were  whites  of  foreign 
birth,  and  of  the  persons  admitted  to  such  institutions  during 
the  year  1910,  25.5  per  cent  were  of  this  class.  Of  the  total 
population  of  the  United  States  in  1910  the  foreign-born 
whites  constituted  14.5  per  cent.  It  is  evident,  then,  that  the 
foreign  born  have  an  unduly  large  representation  in  insane 
asylums.  There  were,  in  fact,  405.3  foreign-born  whites  in 
insane  asylums  to  each  100,000  in  total  population ;  while  for 
the  native  whites  the  ratio  was  168.7  to  100,000;  the  num- 
ber of  admissions  during  the  year  was  116.3  per  100,000  in 


228  RACE  DECADENCE 

the  case  of  the  foreign-born  whites,  as  compared  with  57.9 
in  the  case  of  native  whites. 

The  ratios,  however,  if  regarded  as  an  index  of  the 
tendency  to  insanity  among  immigrants  as  compared  with 
the  native  population  are  somewhat  misleading,  for  the  rea- 
son that  the  difference  between  the  two  classes  is  partly 
accounted  for  by  the  mere  fact  that  the  native  population 
includes  large  numbers  of  children,  while  the  foreign  born 
comprises  comparatively  few,  most  immigrants  being  past  the 
period  of  childhood  when  they  arrive  in  the  United  States. 
Of  the  native  white  population  of  the  United  States  36.5  per 
cent  were  under  15  years  of  age,  while  of  the  foreign-born 
white  population  only  5.7  per  cent  were  below  that  age.  As 
indicated  by  the  age  statistics,  insanity  is  a  defect  which,  as 
a  rule,  makes  its  appearance  only  in  adult  years.  Therefore 
this  difference  in  age  is  bound  to  have  a  marked  effect  upon, 
the  relative  number  of  insane  in  the  two  classes,  and,  other 
things  being  equal,  would  of  itself  make  the  percentage  of 
insane  much  higher  for  the  foreign-born  white  population 
than  for  the  native.  Appendix  A,  Table  No.  9,  makes  a  com- 
parison of  age  periods  showing  what  proportion  of  foreign- 
born  white  and  the  native  white  in  each  age  group  were 
admitted  to  insane  asylums  in  the  year  1910. 

The  practice  of  dumping  their  insane,  criminal,  and  defec- 
tive stock  on  America  was  early  begun  by  Great  Britain,  Hol- 
land, and  other  European  countries.  In  the  early  colonial 
days  the  various  states  had  great  difficulty  in  protecting 
themselves  from  these  undesirable  denizens  who  were  landed 
on  our  shores  in  shiploads.  So  it  will  be  seen  that  America 
had  more  than  her  just  proportion  of  insane  and  defective 
citizens  to  begin  with,  while  we  have  done  little  or  nothing 
to  prevent  their  undue  multiplication  since  we  became  an 
independent  people. 

That  our  increased  insanity  is  partly  due  to  immigration, 


IS  INSANITY  INCREASING?  229 

is  indicated  by  the  immense  and  constantly  increasing  insane 
population  of  the  state  of  New  York,  where  most  immigrants 
land.  In  some  cases,  people  who  actually  show  some  form 
of  insanity  may  slip  past  the  examiners;  in  the  bulk  of 
cases,  probably,  an  individual  is  adapted  to  leading  a  nor- 
mal life  in  his  native  environment,  but  transfer  to  the 
more  strenuous  environment  of  an  American  city  proves  to 
be  too  much  for  his  nervous  organization.  The  general  flow 
of  population  from  the  country  to  large  cities  has  a  similar 
effect  in  increasing  the  number  of  insane. 

INSANITY  AMONG   NEGROES 

The  187,791  insane  in  hospitals  enumerated  on  January 
I,  1910,  included  12,910  Negroes,  and  the  60,769  insane 
admitted  to  hospitals  in  the  year  1910,  included  4,384 
Negroes.  The  Negroes  thus  constituted  about  6.9  per  cent 
of  the  insane  enumerated  on  January  i,  and  7.2  per  cent  of 
the  insane  admitted  during  the  year,  while  of  the  total  popula- 
tion of  the  United  States  they  constituted  a  little  over  10 
per  cent.  Taking  the  country  as  a  whole,  therefore,  the 
Negroes  in  proportion  to  their  number  have  fewer  repre- 
sentatives in  insane  asylums  than  the  whites. 

For  Negroes  the  number  of  admissions  per  100,000  popu- 
lation was  44.6 ;  for  the  whites  it  was  68.7.  Equally  marked 
is  the  contrast  as  regards  the  ratio  of  inmates  present  on 
January  i  —  131.4  per  100,000  for  Negroes  as  compared 
with  213.2  per  100,000  for  whites. 

The  fact  that  the  Negroes  in  the  South  have  a  lower 
ratio  of  admissions  than  the  whites  does  not  necessarily  indi- 
cate that  insanity  is  less  prevalent  in  one  race  than  in  the 
other.  The  difference  in  the  relative  numbers  admitted  to 
asylums  for  the  insane  may  be  influenced  by  the  local  dis- 
tribution of  the  two  races,  by  their  practice  as  regards  taking 
steps  to  have  the  insane  placed  under  institutional  care,  and 


230  RACE  DECADENCE 

by  the  relative  sufficiency  of  the  provisions  made  for  caring 
for  the  insane  of  each  race.  What  the  effect  of  such  factors 
may  be  it  is  difficult  to  determine,  but  it  seems  probable  that 
they  furnish  at  least  a  partial  explanation  of  the  differences 
between  the  two  races  as  regards  the  proportionate  numbers 
admitted  to  institutions  for  the  insane.  It  is  furthermore 
probable  that,  because  of  illiteracy,  poverty,  and  ignorance, 
among  the  Negroes,  cases  of  insanity,  especially  those  which 
are  forms  of  senile  dementia,  are  less  likely  to  be  diagnosed 
or  detected  in  this  race  than  among  the  whites. 

SUMMARY  OF  THE  CHAPTER 

1.  Hereditary  insanity  is  increasing.    At  last  census  there 
were  about  250,000  insane  in  366  public  asylums  in  this 
country. 

2.  This  alarming  increase  in  insanity  on  both  sides  of  the 
Atlantic  is  commonly  regarded  as  an  evidence  of  race  deca- 
dence. 

3.  In  Great  Britain  the  increase  in  population  in  fifty-two 
years  was  85.5  per  cent;  while  insanity  increased  262.2  per 
cent  during  the  same  period. 

4.  There  is  estimated  to  be  about  300,000  insane  and 
feeble-minded  in  England  and  Wales. 

5.  In  the  United  States  we  have  one  insane  person  in  the 
asylums  for  every  350  population.     Estimates  give  one  in- 
sane for  every  280  population. 

6.  Statistics  throughout  the  country  indicate  that  insanity 
is  increasing  anywhere  from  two  to  three  times  faster  than 
the  population. 

7.  The  apparent  ratio  of  the  increase  in  insanity  for  the 
last  fifty  years  if  kept  up  in  the  future,  would  show  the 
whole  population  insane  by  A.D.  2250. 

8.  The  error  in  our  statistics  on  insanity  is  due  to  over- 
looking of  several  vital  points,  viz.,  better  classification,  identi- 
fication, and  segregation.    Things  are  bad  —  but  not  as  bad 
as  they  seem. 

9.  One  authority  estimates  that  one  person  in  every  150, 


IS  INSANITY  INCREASING?  231 

in  this  country,  is  either  insane  or  mentally  unbalanced, 
while  one  person  in  every  5  is  predisposed  to  insanity  by 
heredity. 

10.  There  is  evidence  to  support  the  belief  that  about  I 
per  cent  of  the  population  of  England  and  America  is  in- 
sane or  mentally  defective. 

11.  There  are  10,000,000  poverty  stricken  and  4,000,000 
actual  paupers  in  the  United  States. 

12.  In  twenty-five  years  the  ratio  of  insanity  has  risen 
from  i  to  450  of  population  to  I  for  300. 

13.  More  insanity  is  found  in  older  communities;  less  in 
the  newly  settled  districts. 

14.  Insanity  is  more  prevalent  in  the  cities.    The  popula- 
tion is  concentrating  in  the  cities  and  this  may  be  a  factor  in 
the  increase  of  mental  disorders. 

15.  Among  influences  which  make  it  unduly  appear  that 
insanity  is  increasing  are :  increase  in  average  length  of  life, 
better  diagnostication,  and  more  general  institutional  care 
for  such  patients. 

r6.  While  insanity  may  not  be  increasing  three  hundred 
times  faster  than  the  population  (as  statistics  may  show)  ; 
nevertheless  its  steady  gain  constitutes  a  national  threat  — 
a  race  menace. 

17.  In  the  main,  insanity  is  hereditary;  but  it  is  also 
caused  by:  syphilis,  alcohol,  drugs,  brain  tumors,  and  may 
follow  certain  diseases. 

1 8.  Those  who  "  go  crazy  "  over  love  affairs  and  who 
"  blow  up  "  as  a  result  of  business  troubles,  belong  to  the 
hereditary  type  of  mental  defectives. 

19.  Fully  one-half,  if  not  more,  of  all  our  insanity  belongs 
to  the  hereditary   form.     Dementia  praecox  and  maniac- 
depressive  insanity  are  nearly  always  hereditary. 

20.  The  chief  defect  in  our  management  of  the  insane  is 
that  we  turn  them  loose  (as  temporarily  cured)  periodically, 
to  go  back  home  and  reproduce  their  defective  stock. 

21.  The  causes  of  insanity  in  this  country  are,  roughly: 
heredity,  one-half;  syphilis,  one-sixth;  alcohol  and  drugs, 
one-sixth;  and  various  other  diseases  (tumors,  etc.),  one- 
sixth. 

22.  Marriage  laws  relating  to  the  insane  —  especially  dis- 


232  RACE  DECADENCE 

charged  patients  —  are  in  urgent  need  of  thoroughgoing  re- 
vision. 

23.  People  do  not  go  insane   from  passing  stress  and 
strain  unless  they  are  already  "  insane  carriers  "   —  unless 
they  are  the  product  of,  and  the  carriers  of,  defective  germ- 
plasm. 

24.  About  one-quarter  of  those  admitted  to  insane  asy- 
lums have  been  there  before  —  they  are  recurrent  cases  — 
having  been  previously  committed  from  two  to  four  or  five 
times. 

25.  About  30,000  insane  are  "discharged"   each  year; 
5,000  unimproved;  all  of  whom  may  contribute  legitimate 
or  illegitimate  offspring  to  the  next  generation. 

26.  Not  only  has  recent  immigration  fed  our  stream  of 
insanity,  but  it  was  liberally  stocked  up  in  pre-Revolutionary 
days  by  the  practice  of  European  countries  dumping  their 
insane  and  defectives  on  the  American  colonies. 

27.  Insanity  among  immigrants  shows  unduly  high,  be- 
cause of  the  scarcity  of  children;  while  among  the  Negroes 
it  shows  surprisingly  low,  because  few  are  confined  in  in- 
stitutions. 


CHAPTER  XVI 
FEEBLE-MINDEDNESS 

FEEBLE-MINDEDNESS  has  been  broadly  defined 
as  comprising  all  degrees  of  mental  defect  due  to  ar- 
rested or  imperfect  mental  development  as  a  result  of  which 
the  person  so  affected  is  incapable  of  competing  on  equal 
terms  with  his  normal  fellows,  or  of  managing  himself  or 
his  affairs  with  ordinary  prudence.  The  feeble-minded,  as 
thus  defined,  range  in  mental  development  from  those  whose 
mentality  does  not  exceed  that  of  a  normal  child  of  2  years 
to  those  whose  mentality  is  as  high  as  that  of  a  child  of  12. 
Th«e  great  majority  of  the  feeble-minded  are  not  confined 
in  institutions,  but  live  at  large ;  many  are  inmates  of  pris- 
ons and  reformatories;  many  others  are  in  almshouses,  and 
some  are  even  confined  in  hospitals  for  the  insane.  Only  a 
small  fraction  of  the  feeble-minded  are  taken  care  of  in  spe- 
cial institutions  designed  for  that  class,  but  the  development 
of  recent  years  is  in  the  direction  of  providing  such  special 
institutions.  (See  Fig.  13.) 

DEFINITION   OF  FEEBLE-MINDEDNESS 

Some  experts  will  define  a  feeble-minded  person  as  one 
who  cannot  meet  all  (save  two)  of  the  Binet  tests  for  three 
years  below  his  own;  if  he  fail  in  only  one  he  is  no  longer 
feeble-minded.  But  this  definition  is  not  quite  satisfactory 
because  there  are  any  number  of  moral  imbeciles  who  can 
answer  all  but  the  moral  question  for  their  proper  age.  Prob- 
ably the  best  definition  of  feeble-mindedness  would  be,  "A 
person  who  is  deficient  in  some  socially  important  trait," 

233 


234  RACE  DECADENCE 

and  then  the  class  as  a  whole  would  include  the  sexually  im- 
moral, the  criminalistic,  those  who  cannot  control  their  use 
of  narcotics,  those  who  habitually  tell  lies  by  preference,  and 
the  truants  —  those  who  run  away  from  school  or  home.  If 
from  the  class  of  "  feeble-minded  "  we  exclude  the  sexually 
immoral,  the  criminalistic,  and  the  victim  of  narcotics,  we 
would  have  left  largely  the  lower  grades  of  defectives;  on 
the  other  hand,  if  we  include  the  morons  we  would  have 
an  enormously  enlarged  group  of  degenerates. 

The  definition  proposed  by  the  English  Royal  Commission 
is  in  point :  "A  '  feeble-minded '  person  is  one  who  can 
make  his  living  under  favorable  circumstances,  but  who  is 
incapable  of  competing  on  equal  terms  with  his  normal 
fellows,  or  of  conducting  himself  with  ordinary  prudence." 
But  there  are  any  number  of  persons  who  cannot  compete  on 
equal  terms  with  their  normal  fellows,  who  are  not  feeble- 
minded ;  they  may  be  only  dull,  backward,  or  retarded. 

Healy  describes  three  types  of  mental  abnormality  — 
mental  defects,  mental  aberrations,  and  mental  peculiarities. 
Sometimes  we  cannot  sharply  divide  these  classes.  The 
mental  defective  may  have  aberrational  states  superadded; 
between  mere  mental  peculiarities  and  real  aberration,  differ- 
entiation at  times  is  often  impossible.  The  main  types  stand 
out  with  great  clearness,  but  indefiniteness  for  classification 
besets  the  border  lines. 

To  make  clear  the  subclasses  of  mental  abnormality  is  the 
purpose  of  the  accompanying  scheme.  (See  Fig.  14.) 

The  best  classification  of  defectives  is  that  adopted  by  the 
American  Association  for  the  Study  of  Feeble-mindedness 
in  1910.  This  body  of  experienced  scientific  workers  agreed 
to  use  the  word  "  feeble-minded  "  as  a  generic  term  under 
which  there  should  be  the  subclasses:  idiots,  imbeciles,  and 
morons. 

According  to  the  works  of  Goddard  and  others,  defectives 


FEEBLE-MINDEDNESS  235 

who  are  able  to  get  through  the  Binet  test  for  12  years  are 
practically  never  to  be  found  in  institutional  life.  That  is 
to  say  individuals  of  mental  ages  above  12  are  at  least  in  some 
degree  regarded  as  socially  acceptable. 

The  American  Association  has  set  forth  the  following 
practical  scheme  of  diagnosis :  Idiots  are  those  who  are  able 
to  do  the  Binet  mental  tests  up  to  the  level  of  the  normal 
child  of  2  years ;  imbeciles  are  able  to  do  the  tests  performed 
by  a  normal  child  between  the  ages  of  2  and  7  years ;  morons 
are  those  who  equal  the  mental  performance  of  a  child  be- 
tween the  ages  of  7  and  12  years. 

Idiots. —  The  group  of  individuals  properly  designated 
under  modern  nomenclature  as  idiots  rarely,  if  ever,  are 
criminals.  In  practically  all  classes  they  are  found  so  intol- 
erable socially  on  account  of  their  mental  defect  that  they 
are,  early  segregated  in  public  institutions. 

Imbeciles. —  The  middle  grade  of  feeble-minded,  imbeciles, 
are  more  frequently  met  with,  but  are  not  at  all  numerous. 

Morons. —  Of  much  more  importance,  so  far  as  society  is 
concerned,  is  the  upper  grade  of  feeble-minded,  the  class  of 
the  morons.  As  we  go  up  in  the  scale  of  mentality  we  nat- 
urally find  more  ability  to  make  trouble  in  the  social  body. 

FEEBLE-MINDEDNESS  IN  THE  UNITED  STATES 

In  connection  with  the  population  censuses  from  1850  to 
1890,  inclusive,  the  attempt  was  made  to  enumerate  all  the 
mentally  defective  in  the  general  population.  The  methods 
adopted  in  different  years  were  not  uniform,  and  the  results 
cannot  be  regarded  as  complete  or  comparable.  In  case  of 
the  feeble-minded  the  comparability  of  the  returns  is  also 
affected  by  the  fact  that  from  1850  to  1880  the  enumeration, 
according  to  the  terms  used,  covered  chiefly,  if  not  entirely, 
those  whose  idiocy  or  imbecility  was  apparent.  With  in- 
creasing study  of  the  defective  classes,  however,  there  arose 


Mental 
abnormalities 


Feeble-minded 


Mental  defects 


Mental  dullness 
from  physical 
conditions 


Psychic  constitu- 
tional inferiority 


Mental  aberration 
Insanities 
Psychoses 
.  Psychopathies 


,  Mental  peculiarity 


f  Idiot 
•I  Imbecile 
[  Moron 


Subnormal — 
Backward 

Defective  only  in 
some  special 
ability 


Major  types 


Minor  types 


Fig.  14.     Scheme  of  classification  of  mental  abnormalities 

(After  Healy) 


FEEBLE-MINDEDNESS  237 

a  conviction  that  there  were  many  on  the  borderland  of  men- 
tal deficiency,  who,  though  not  entirely  helpless  or  depend- 
ent, were  possibly  an  even  greater  menace  to  society  than 
those  who  were.  They  were  evidently  not  idiots,  in  the  ordi- 
nary acceptance  of  the  word,  and  the  term  "  feeble-minded  " 
was  adopted  in  the  report  for  1890  and  has  been  used  ever 
since.  After  that  time,  however,  no  general  enumeration  of 
this  large  and  ill-defined  class  has  been  attempted  by  the 
Bureau  of  the  Census.  In  1904  and  again  in  1910  the  census 
was  restricted  to  the  inmates  of  special  institutions  for  this 
class. 

An  important  factor  affecting  comparisons  of  different 
periods  is  the  change  that  has  taken  place  in  the  general 
methods  of  care  for  the  feeble-minded.  Formerly  almost  all 
of  this  class  under  institutional  care  were  in  almshouses  or 
in  asylums  for  the  insane.  As  late  as  1890  only  sixteen 
states  had  provided  separate  institutions  for  the  feeble- 
minded, and  the  number  of  such  institutions  was  only 
twenty-four.  In  1904  the  number  of  institutions  had  in- 
creased to  forty-two,  and  the  number  of  states  making  such 
provisions  was  twenty-five.  In  1910  there  were  sixty-three 
institutions  reported  by  thirty-one  states. 

At  present  there  are  few  states  which  make  no  special  pro- 
vision for  this  class  of  defectives. 

The  effect  of  these  conditions  upon  the  statistics  is  ap- 
parent. In  the  1890  census  the  institutional  population, 
enumerated  as  feeble-minded,  included  5,254  in  special  in- 
stitutions and  2,469  in  hospitals  for  the  insane ;  and,  in  ad- 
dition to  these,  7,811  inmates  of  almshouses  were  returned 
as  "  idiots,"  making  a  total  of  15,534  feeble-minded,  or  idiots. 
In  1904  the  number  in  special  institutions  had  risen  to  14.347 
and  in  1910  to  20,731.  The  1904  and  1910  censuses  of  the 
insane  in  hospitals  made  no  separate  enumeration  of  the 
feeble-minded  inmates  of  those  institutions,  nor  was  there 


238 


RACE  DECADENCE 


any  record  of  those  in  reformatories  or  other  correctional  in- 
stitutions; but  the  1904  report  on  paupers  showed  16,551  in- 
mates of  almshouses  classed  as  feeble-minded,  which  number 
was  reduced  in  the  report  for  1910  to  13,238.  On  January 
I,  1904,  a  total  of  30,898  feeble-minded  persons  were  either 
in  special  institutions  or  in  almshouses,  and  on  January  I, 
1910,  a  total  of  33,969. 


FEEBLE-MINDEE 

> 

YEAR 

In  special 
institutions 

In  almshouses 

In   hospitals 
for  the  insane 

1910.  . 

20,731 

13,238 

t 

1904  

14,347 

16,551 

1890.  . 

5,254 

*7,811 

2,469 

*Not  reported.         flndudes  only  those  classed  as  "  idiots." 

Less  than  10  per  cent  of  our  feeble-minded  population  is 
confined  in  our  colonies  or  institutions  for  the  feeble-minded. 
The  state  of  Minnesota  cares  for  one  feeble-minded  person 
in  its  large  colony  for  the  feeble-minded  to  every  1,281  per- 
sons in  the  general  population  of  the  state.  The  correspond- 
ing figures  for  Iowa  are  i  to  1,504;  for  Indiana  i  to  2,207; 
for  Kansas  i  to  3,493 ;  and  for  Illinois  i  to  3,883.  Missouri, 
on  the  other  hand,  cares  for  only  one  feeble-minded  person 
to  every  6,977  in  the  general  population. 

As  will  be  seen,  it  is  quite  impossible  to  ascertain  the 
actual  number  of  feeble-minded  in  this  country  at  the  present 
time  —  we  know  about  those  only  in  state  institutions. 

In  1900  Great  Britain  reported  having  1,527  imbeciles  per 
1,000,000  of  population. 

There  are  probably  no  less  than  300,000  out-and-out  fee- 
ble-minded persons  in  the  United  States  —  and  this  does* 
not  take  into  consideration  the  enormous  and  unknown  num- 
ber of  individuals  whose  taint  of  feeble-mindedness  is  latent, 
but  whose  tainted  germ-plasm  is  sure  to  transmit  its  defec- 
tive strain  to  succeeding  generations.  Some  of  these  latent 


FEEBLE-MINDEDNESS  239 

or  masked  cases,  as  individuals,  may  show  fair  mental  devel- 
opment, and  are,  therefore,  in  many  respects,  all  the  more 
dangerous  and  deceptive  to  the  rest  of  society. 

Almost  50,000  feeble-minded  and  mentally  deficient  indi- 
viduals were  turned  up  by  the  examinations  of  the  selective 
military  draft.  Dr.  Pierce  Bailey,  Chairman  of  the  New 
York  State  Commission  on  Mental  Defectives,  is  authority 
for  the  statement,  that  nervous  and  mental  diseases  numbered 
60,000,  and  ran  especially  high  among  the  immigrant  classes 
of  New  York.  Medical  authorities  believe  that  the  general 
population  will  show  almost  twice  the  amount  of  feeble- 
mindedness that  was  shown  among  those  drafted  between 
the  ages  of  21  and  31. 

The  number  of  inmates  in  the  American  institutions  for 
the  feeble-minded  in  1914,  according  to  the  report  of  the 
Corqmissioner  of  Education,  was  28,878.  Of  these  916  were 
in  private  institutions  and  27,962  in  state  institutions  (the 
state  institutions,  however,  include  two  villages  for  epi- 
leptics). How  many  feeble-minded  persons  are  at  large 
in  society  and  how  many  are  confined  in  improper  types  of 
institutions  is  not  known.  The  estimates  frequently  hazarded 
are  mere  conjectures.  Indeed,  we  are  lacking  scientifically 
accurate  data  to  show  what  percentage  of  the  inmates  in  the 
public  and  private  institutions  are  actually  feeble-minded. 

STANDARDS   OF    FEEBLE-MINDEDNESS 

Who  is  feeble-minded?  Langmead  in  discussing  this 
question  says :  "  I  do  not  think  that  we  can  label  a  child  as 
defective  in  mind  by  a  fixed  test,  or  set  of  tests,  no  matter 
how  carefully  thought  out.  .  .  .  Judged  by  them  alone, 
the  minds  of  many  children  who  are  not  mentally  defective 
will  be  weighed  in  the  balance  and  found  wanting." 

Speaking  of  the  Binet  scale,  Healy  declares :  "  This 
scale,  it  may  at  once  be  said,  is  to  be  fairly  employed  merely 


240  RACE  DECADENCE 

as  a  scheme  for  preliminary  diagnosis,  and  like  many  other 
useful  ideas  has  been  given  exaggerated  importance,  as  if 
by  it  one  were  capable  of  measuring  all  the  vast  intricacies 
and  possibilities  of  the  human  mind,  defective  and  normal." 

We  must  conclude,  therefore,  that,  no  matter  how  valuable 
our  mental  tests  may  be  —  and  we  do  not  wish  to  minimize 
their  real  value  —  it  has  not  been  "  mathematically  demon- 
strated "  that  it  is  a  "  marvel  of  accuracy  "  and  that  it  will 
"  tell  us  to  a  nicety  just  where  a  child  stands  in  his  mental 
capacity."  All  we  are  justified  in  saying  is  that  it  possesses 
a  fair  degree  of  accuracy  and  that  it  is  of  considerable  value 
for  the  estimation  of  the  general  intelligence.  Mental  tests 
are  merely  "  tools  "  designed  to  aid  in  making  a  diagnosis. 

The  limit  of  feeble-mindedness  is  not  determined  prima- 
rily by  the  mere  fact  of  the  accuracy  of  a  measuring  scale  of 
intelligence,  but  by  social  criteria,  by  the  degree  of  intelli- 
gence required  by  a  person  to  make  his  living  and  to  con- 
form to  the  laws  and  conventions  of  the  social  levels  in 
which  he  finds  himself. 

Binet's  associate,  Simon,  made  these  statements : 

We  mean  by  the  term  "  idiot "  an  individual  whose  intellectual 
development  is  that  of  2  years  or  under.  We  mean  by  the  term 
"  imbecile  "  an  individual  whose  intellectual  development  corresponds 
to  that  of  a  child  between  the  ages  of  3  and  7  years.  And  finally 
by  the  term  "  feeble-minded"  (debile)  we  mean  an  individual  whose 
intellectual  level,  while  superior  to  that  of  a  child  of  7  years,  is 
nevertheless  below  the  average  development  of  an  adult.  This  lat- 
ter degree  of  development,  as  I  have  said,  is  still  inadequately  de- 
termined. Provisionally  it  might  be  proposed  to  fix  at  9  years  the 
upper  level  of  mental  debility.  ...  A  development  equivalent 
to  the  normal  average  at  9  years  of  age  is  the  minimum  below 
which  the  individual  is  capable  of  getting  along  without  tutelage  in 
the  conditions  of  modern  life.  .  .  .  Nine  years  is  the  intellectual 
level  found  in  the  lowest  class  of  domestic  servants,  in  those  who 
are  just  on  the  border  of  a  possible  existence  of  economic  inde- 
pendence ;  it  is,  on  the  other  hand,  the  highest  level  met  with  in 
general  paralytics  who  come  under  asylum  care  on  account  of  their 
dementia. 


FEEBLE-MINDEDNESS  241 

While  all  authorities  are  not  agreed  in  every  respect  as  to 
the  standard  for  determining  f  eeble-mindedness,  we  think  the 
standard  adopted  by  the  American  Association  for  the  Study 
of  Feeble-mindedness  —  the  one  already  presented  —  is  one 
designed  acceptably  to  serve  all  practical  purposes. 

ORIGIN   OF   FEEBLE-MINDEDNESS 

A  British  commission  for  the  study  of  this  subject  came 
to  the  following  conclusions  respecting  the  probable  origin 
of  f eeble-mindedness : 

1.  That  both  on  grounds  of  fact  and  theory  there  is  the 
highest  degree  of  probability  that  f  eeble-mindedness  is  usu- 
ally spontaneous  in  origin  —  that  is,  not  due  to  influences 
acting  on  the  parent  —  and  tends  strongly  to  be  inherited. 

2.  That,   especially  in  view  of  the  evidence  concerning 
fertility,  the  prevention  of  mentally  defective  persons  from 
becoming  parents  would  tend  largely  to  diminish  the  num- 
ber of  such  persons  in  the  population. 

3.  That  the  evidence  for  these  conclusions  strongly  sup- 
ports measures,  which  on  other  grounds  are  of  pressing 
importance,  for  placing  mentally  defective  persons,  men  and 
women,  who  are  living  at  large  and  uncontrolled,  in  institu- 
tions where  they  will  be  employed  and  detained;  and  in 
this,  and  other  ways,  kept  under  effective  supervision  so  long 
as  may  be  necessary. 

A  little  study  will  render  it  evident  that  one  of  the  essen- 
tial defects  of  the  feeble-minded  person,  the  idiot,  and  the 
imbecile,  is  lack  of  memory,  lack  of  association  of  ideas. 
They  are  unable  to  profit,  like  the  normal  individual,  from 
experience.  This  defect  of  memory  may  be,  and  usually 
is,  general,  so  that  the  individual  is  able  to  learn  very  little ; 
or  the  defect  may  be  limited  to  some  particular,  as  in  case 
of  those  who  are  unable  to  acquire  the  code  of  conventional 
morals  prevailing  in  the  community  in  which  they  live. 


242  RACE  DECADENCE 

The  truth  that  the  higher  intellectual  faculties  are  less  de- 
veloped in  the  feeble-minded  than  the  lower  faculties  is  due 
entirely  to  the  fact  that  the  former  can  be  acquired  only  by 
people  whose  mental  powers  are  more  or  less  normal.  In 
effect  and  in  fact  the  feeble-minded  person  is  an  instance 
of  reversion  to  a  prehuman  mental  state.  Judged  by  the 
human  standard,  every  dog  and  monkey  is  an  imbecile. 
But  the  reversion  of  the  imbecile  is  not  complete;  for, 
while  he  has  lost  part  of  his  power  of  profiting  by  experi- 
ence, he  has  regained  no  part  of  the  lost  power  of  being 
properly  guided  by  instinct ;  he  is,  therefore,  correspondingly 
helpless  as  compared  to  a  lower  animal.  On  the  other  hand, 
the  instincts  (e.  g.,  the  sexual)  which  normal  human  beings 
still  possess  often  appear  unduly  prominent  —  simply  be- 
cause he  cannot  learn  to  control  them. 

FEEBLE-MINDEDNESS  AND   HEREDITY 

There  is  every  reason  to  believe  that  at  least  two-thirds 
of  the  feeble-mindedness  in  this  country  is  directly  due  to 
heredity.1  This  is  not  only  a  serious  problem  for  the 
present  generation,  but  one  that  is  even  more  serious  for  all 
future  generations,  because  of  the  fact  that  a  very  great  num- 
ber of  these  feeble-minded  of  the  present  generation  will 
surely  transmit  their  defects  and  degeneracy  to  a  large 
per  cent  of  their  descendants. 

Feeble-minded  persons  from  sound  stock,  whose  arrested 
development  is  due  to  scarlet  fever  or  some  other  severe 
disease  of  childhood,  or  to  accident,  are  of  course  not  to  be 
feared  in  this  connection. 

Feeble-mindedness  is  a  mental  defect  which  is  highly 
hereditary.  Some  eugenists  have  even  thought  it  to  be  a 


1  Feeble-Mindedness,  by  Henry  H.  Goddard,  director  department 
of  research,  Training  School  for  Feeble-Minded  Children,  Vineland, 
N.  J.  The  Macmillan  Company,  New  York,  1914. 


FEEBLE-MINDEDNESS  243 

true  "  unit  character."  When  two  inherently  feeble-minded 
persons  marry,  all  of  their  offspring,  almost  without  excep- 
tion, are  destined  to  be  feeble-minded.  The  feeble-minded 
are  never  of  much  real  value  to  society  —  they  never  present 
such  instances  as  are  found  among  the  insane,  of  persons 
with  some  mental  lack  of  balance,  but  who  sometimes  belong 
to  the  order  of  geniuses  or  near-geniuses. 

Tredgold,  the  well-known  English  authority,  believes  that 
in  the  case  of  mental  unsoundness,  such  as  lunacy,  idiocy, 
imbecility  (feeble-mindedness),  at  least  90  per  cent  of  these 
cases  may  be  traced  to  heredity. 

Mr.  David  Heron,  and  others,  have  shown  that  while  there 
has  been  a  marked  decline  in  the  birth-rate  of  the  popula- 
tion in  general,  the  diminution  is  almost  entirely  confined  to 
the  healthy  and  thrifty  class.  In  a  section  of  population 
numbering  1,250,000  persons,  thrifty  and  healthy  artisans, 
the  decline  in  the  birth-rate  in  twenty-four  years,  1880  to 
1904,  was  over  52  per  cent,  or  three  times  that  in  England 
and  Wales  as  a  whole. 

Study  of  a  large  number  of  families  of  the  working 
class  of  incompetent  and  parasitic  character  revealed  that 
the  average  number  of  children  to  the  family  was  7.4,  while 
in  thrifty  and  competent  working  families  the  number  was 
3.7.  In  other  words,  the  incompetent  and  defective  classes 
are  multiplying  far  more  rapidly  than  are  the  competent 
and  efficient.  Heredity  explains  most  of  our  mental  defec- 
tiveness  and  moral  degeneracy  —  our  racial  decadence;  and 
the  control  of  heredity  —  the  regulation  of  the  offspring  of 
these  defectives  —  presents  the  only  avenue  of  hope  for 
dodging  the  inevitable  social  catastrophe  toward  which  we 
are  certainly  headed,  if  no  preventive  measures  are  set  in 
operation  in  the  near  future.  The  defectives  are  doubling 
their  numbers  each  generation  while  the  desirables  are  not 
quite  reproducing  themselves. 


244  RACE  DECADENCE 

ILLUSTRATION  OF  THE  INHERITANCE  OF  FEEBLE-MINDEDNESS 

Goddard  has  recently  published  several  family  histories 
showing  the  inheritance  of  feeble-mindedness.  One  of  the 
most  significant  of  these  —  significant  both  socially  and 
eugenically  —  is  summarized  as  follows :  "  Here  we  have 
a  feeble-minded  woman  who  has  had  three  husbands  (includ- 
ing one  '  who  was  not  her  husband  ')  and  the  result  has  been 
nothing  but  feeble-minded  children."  The  story  may  be  told 
as  follows:  This  woman  was  a  handsome  girl,  apparently 
having  inherited  some  refinement  from  her  mother,  although 
her  father  was  a  feeble-minded,  alcoholic  brute.  Somewhere 
about  the  age  of  17  or  18  years  she  went  out  to  do  house- 
work in  a  family  in  one  of  the  towns  of  this  state  (New 
Jersey).  She  soon  became  the  mother  of  an  illegitimate 
child.  It  was  born  in  an  almshouse  to  which  she  fled  after 
she  had  been  discharged  from  the  home  where  she  had  been 
at  work.  After  this,  charitably  disposed  people  tried  to 
do  what  they  could  for  her,  giving  her  a  home  for  herself 
and  her  child  in  return  for  the  work  which  she  could  do. 
However,  she  soon  appeared  in  the  same  condition.  An 
effort  was  then  made  to  discover  the  father  of  this  second 
child,  and  when  he  was  found  to  be  a  drunken,  feeble- 
minded epileptic  living  in  the  neighborhood,  in  order  to 
save  the  legitimacy  of  the  child,  her  friends  (sic)  saw  to 
it  that  a  marriage  ceremony  took  place.  Later,  another 
feeble-minded  child  was  born  to  them.  Then  the  whole 
family  secured  a  home  with  an  unmarried  farmer  in  the 
neighborhood.  They  lived  there  until  another  child  was 
forthcoming  which  the  husband  refused  to  own.  When, 
finally,  the  farmer  acknowledged  this  child  ,to  be  his,  the 
same  good  friends  (sic)  interfered,  went  into  the  courts 
and  procured  a  divorce  from  the  husband  and  had  the 
woman  married  to  the  father  of  the  expected  fourth  child. 


FEEBLE-M1NDEDNESS  245 

This  proved  to  be  feeble-minded,  and  they  have  had  four 
other  feeble-minded  children,  making  eight  in  all  born  of  this 
woman.  There  has  also  been  one  child  stillborn  and  one 
miscarriage. 

This  woman  had  four  feeble-minded  brothers  and  sisters. 
These  are  all  married  and  have  children.  The  older  of  the 
two  sisters  had  a  child  by  her  own  father,  when  she  was  13 
years  old.  The  child  died  at  about  6  years  of  age.  This 
woman  has  since  married.  The  two  brothers  have  at  least 
one  child,  of  whose  mental  condition  nothing  is  known. 
The  other  sister  married  a  feeble-minded  man  and  had  three 
children.  Two  of  these  are  feeble-minded  and  the  other  died 
in  infancy. 

The  parental  ancestry  of  this  unfortunate  woman  is  hardly 
less  interesting.  All  told,  this  family  history,  as  far  as  it  is 
known,  includes  59  persons ;  the  mental  character  of  12  of 
these  is  unknown;  10  died  in  infancy,  or  before  their  char- 
acteristics were  known ;  of  the  remaining  37,  30  were  feeble- 
minded. 

THE  TAINTED  STREAM  OF  LIFE 

Of  all  the  calamities  that  can  befall  a  human  being  feeble- 
mindedness is,  undoubtedly,  the  worst.  From  most  misfor- 
tunes it  is  possible,  in  some  degree,  to  recover ;  with  many  of 
the  rest  one  may  at  least  continue  to  live  without  detriment 
to  the  race.  To  be  feeble-minded  simply  means  to  hark  back 
to  the  level  of  our  animal  ancestors,  without  the  compensation 
of  regaining  their  instinctive  powers.  The  animal  is  provided 
with  a  bundle  of  instincts  which  tell  him  what  to  do  in  all  the 
ordinary  emergencies  of  life.  The  human  species,  in  its  de- 
velopment, has  largely  lost  this  biologic  instinct,  and  has 
gained,  instead,  the  power  pf  intelligent  choice  and  the  ability 
to  learn  by  experience  and  by  imitation. 

Modern  science  is  making  clear  to  us  that  a  large  part  of 


246  RACE  DECADENCE 

the  criminality  and  immorality  of  the  world,  together  with 
much  of  the  alcoholic  excesses  are  due  to  this  inherited  taint 
of  feeble-mindedness.  Prisons,  almshouses,  and  houses  of 
shame  owe  their  population  in  no  small  degree  to  this  bitter 
curse.  How  long  will  it  be  before  society  will  learn  to  protect 
itself  against  such  poisoning  of  the  stream  of  life? 

There  is  one  type  of  mental  weakling,  known  as  the  Mon- 
golian idiot,  which  may  arise  right  out  of  the  heart  of  an 
apparently  sound  family.  But  the  number  of  these  is  com- 
paratively small ;  while  the  number  of  feeble-minded  who  are 
feeble-minded  because  of  their  heredity  is  dishearteningly  and 
astonishingly  large.  Every  school  has  its  backward  children, 
and  every  little  community  has  its  silly  boys  and  half-wit 
girls ;  and  such  defectives  seldom  live  long  lives  without  leav- 
ing behind  their  tainted  and  degenerate  offspring  —  no  small 
proportion  of  whom  are  likely  to  be  illegitimate.  Against  this 
fouling  of  the  stream  at  its  source,  society  must  sooner  or 
later  protect  itself  —  or  face  extinction  as  a  highly  civilized 
and  progressive  organization. 

It  is  alleged  that  30  per  cent  of  the  general  population  are 
carriers  of  neuropathic  defects,  that  15  per  cent  of  the  present 
generation  produces  50  per  cent  of  the  next  generation,  and 
that  this  producing  minority  represents  the  poorer,  lower,  or 
eugenically  inferior  elements  of  the  population.  Tredgold 
claims  that  80  per  cent  of  feeble-mindedness  is  due  to  a 
"  neuropathic  inheritance  "  while  Goddard  holds  that  at  least 
two-thirds  of  the  feeble-minded  have  inherited  their  defect. 
Without  attempting  to  determine  whether  these  estimates  are 
accurate,  it  is  at  least  true  that  heredity  is  one  of  the  most 
potent  factors  in  the  production  of  feeble-mindedness  and  of 
racial  degeneracy. 

For  distribution  of  the  feeble-minded  in  the  United  States, 
see  Appendix  A,  Table  No.  10. 

In  interpreting  these  tables,  it  is  to  be  remembered  that  it 


FEEBLE-M1NDEDNESS  247 

does  not  include  feeble-minded  persons  in  the  general  popu- 
lation, but  only  those  either  in  institutions  specifically  for  this 
class,  or  in  almshouses.  Accordingly,  it  is  indicative  mainly 
of  the  degree  to  which  the  states  have  emphasized  institutional 
care  for  this  class  of  defectives,  and  the  evident  disproportion 
between  the  groups  of  states  does  not  indicate  the  actual  sit- 
uation so  far  as  the  number  of  feeble-minded  in  proportion 
to  the  population  is  concerned.  The  small  numbers  and  the 
low  rate  per  100,000  of  population  in  the  southern  and  west- 
ern divisions  by  no  means  prove  that  feeble-mindedness  is 
not  proportionally  as  prevalent  as  in  the  eastern  and  northern 
divisions,  but  merely  that  the  states  of  those  sections  have  not 
yet  faced  the  problem  of  dealing  with  the  situation.  That 
the  three  great  southern  divisions  should  report  but  six  feeble- 
minded Negroes  in  special  institutions,  all  in  the  one  state 
of  Tennessee,  is  simple  evidence  that  the  southern  states  have 
made  practically  no  provision  for  the  institutional  care  of  this 
class  of  defectives.  As  just  pointed  out,  the  South  and  West 
have  been  backward  in  caring  for  the  feeble-minded. 

Most  of  those  inmates  who  were  discharged  from  institu- 
tions for  the  feeble-minded  in  1910  were  intrusted  to  the  care 
of  relatives  or  friends,  only  55  being  reported  as  discharged 
to  "  keeping  of  self."  As  regards  the  condition  of  those  dis- 
charged, 612,  or  about  61  per  cent  were  reported  as  improved, 
which  includes  those  who  were  cured,  if  any,  and  280  as  un- 
improved, while  for  117  no  report  was  obtained. 

In  the  case  of  those  feeble-minded  persons  "  discharged  " 
it  requires  but  a  small  exercise  of  the  imagination  to  picture 
the  direful  consequences  on  future  generations  of  the  de- 
scendants of  those  "  discharged  "  but  inherently  defective  in- 
mates of  public  asylums.  There  is  no  law  to  prevent  their 
marriage  and  reproduction,  and  even  if  we  had  laws  pro- 
hibiting the  marriage  of  such  "  discharged  "  defectives  even 
such  desirable  laws  would  not  prevent  the  illegitimate  off- 


248  RACE  DECADENCE 

spring  of  such  undesirable  citizens  coming  into  the  world  to 
prove  a  curse  both  to  themselves  and  untold  numbers  of 
others  belonging  to  unborn  generations. 

PHYSICALLY  DEFECTIVE  FEEBLE-MINDED     ' 

Table  No.  8,  Appendix  A,  brings  out  the  significant  fact 
that  a  large  proportion  of  the  feeble-minded  are  also  physi- 
cally defective  —  that  is  blind,  deaf,  crippled,  maimed,  or 
deformed,  paralytic,  or  epileptic.  Out  of  a  total  of  20,731 
persons  enumerated  on  January  I,  1910,  in  institutions  for 
the  feeble-minded,  5,246  or  25.3  per  cent,  are  reported  as  thus 
defective,  while  of  the  3,825  admitted  to  the  institutions  dur- 
ing the  year,  910  or  23.8  per  cent  were  defective. 

It  is  of  some  interest  to  note  that  the  proportion  reported 
as  physically  defective  was  considerably  smaller  in  1910  than 
it  was  in  1904.  Based  on  the  total  number  enumerated  at  the 
beginning  of  the  year  and  admitted  during  the  year,  the  per- 
centage of  physically  defective  declined  from  30.2  in  1904  to 
25.1  in  1910.  The  decline  took  place  principally  in  the  per- 
centage of  epileptics,  which  was  17.8  in  1904  and  n.6  in  1910, 
and  probably  reflects  the  tendency  to  make  special  provision 
for  the  care  of  epileptics  in  colonies  or  separate  institutions. 

THE  DOCTOR'S  ATTITUDE 

We  are  turning  heaven  and  earth  upside  down  by  philan- 
thropic effort,  medical  science,  and  Christianity,  to  save  all 
the  weak  elements  of  our  civilization  —  soup  kitchens,  special 
schools  for  backward  children,  visiting  nurses,  free  dispen- 
saries —  and  1  believe  in  these  things  —  if  it  does  not  do  the 
unfortunates  any  good,  it  certainly  does  us  a  lot  of  good ;  for, 
I  believe  it  is  the  doctor's  business  to  try  to  save  every  child 
that  is  born  into  the  world.  I  do  not  take  any  stock  in  this 
nonsense,  that  doctors  should  let  defective  babies  die  at  birth. 
If  a  baby  is  here  and  a  doctor  can  save  its  life,  it  is  his  busi- 


FEEBLE-MINDEDNESS  249 

ness  to  do  it.  I  do  not  believe  that  any  physician  should  ever 
take  the  power  of  life  and  death  in  his  own  hands. 

But,  if  we  physicians  represent  the  civilized  and  Christian- 
ized sentiment  of  modern  society  in  protecting  the  weak  and 
giving  them  a  fair  and  square  deal  —  if  the  physician  steps 
in  and  saves  that  baby  at  birth  —  and  then  it  grows  to  ado- 
lescence, and  shows  that  it  is  manifestly  defective  and  de- 
generate and  we  know  that  it  can  reproduce  only  its  kind; 
then  we  maintain  that  society  owes  it  to  the  medical  profession 
on  the  one  hand,  and  to  itself  on  the  other,  to  say  in  substance 
to  this  defective  child:  "  We  will  do  our  very  best  for  you, 
you  shall  be  educated  or  trained  up  to  your  fullest  capacity ; 
and  then  you  shall  be  either  segregated  or  sterilized.  We 
will  do  our  full  duty  by  you,  but  there  must  be  no  more  like 
you." 

Itais  a  biological  crime  to  allow  defectives  and  degenerates 
to  reproduce  themselves. 

Delivering  a  lecture  in  a  Wisconsin  town  not  long  ago,  the 
author  was  shown  around  the  new  high  school  with  its 
manual  training  equipment  —  a  wonderful  institution.  In 
one  room  a  young  woman  was  teaching  five  little  deaf-mutes, 
three  of  them  born  of  one  father  and  mother,  both  parents 
being  feeble-minded  paupers.  They  wanted  to  marry  and  the 
people  said :  "  Let  them  get  married  and  settle  down."  They 
have  a  fourth  child  coming  and  it  is  also  sure  to  be  a  deaf- 
mute,  because,  when  the  feeble-minded  mate  with  the  feeble- 
minded, the  offspring  are  practically  100  per  cent  defective  or 
feeble-minded.  If  one  side  is  normal  and  the  other 
affected,  then  it  operates  somewhere  near  the  Mendelian 
ratio  of  3  to  i,  or  75  per  cent  of  the  total  affected, 
and  25  per  cent  apparently  normal  —  but  carriers  of  the  de- 
fective strain  over  into  the  next  generation. 

There  are  a  lot  of  things  we  do  not  know  about  breeding 
and  about  heredity,  but  there  are  some  things  we  do  know, 


•2$0  RACE  DECADENCE 

and  the  time  has  come  to  do  something,  to  put  into  practical 
working  the  light  and  information  we  possess. 

SUMMARY  OF  THE  CHAPTER 

1.  Probably  the  best  definition  for  feeble-mindedness  is 
"  a  person  who  is  deficient  in  some  socially  important  trait." 

2.  Persons  are  commonly  regarded  as  being  feeble-minded 
when  they  fail  to  meet  all  (save  two)  of  the  Binet  tests  for 
three  years  below  their  own. 

3.  The  English  definition  is :    "  One  who  is  incapable  of 
competing  on  equal  terms  with  his  normal  fellows,  or  of  con- 
ducting himself  with  ordinary  prudence." 

4.  We  use  "  feeble-mindedness  "  as  a  general  term  embrac- 
ing mental  def  ectiveness  in  general ;  and  specifically  including 
the  subclasses  of  idiots,  imbeciles,  and  morons. 

5.  Idiots  are  those  who  can  do  the  Binet  tests  up  to  the 
level  of  a  normal  child  of  2  years. 

6.  Imbeciles  are  those  who  do  the  Binet  tests  for  the  nor- 
mal child  between  2  and  7  years. 

7.  Morons  are  the  ones  who  do  the  tests  for  the  normal 
child  up  to  12  years  of  age. 

8.  There  are  only  sixty-three  institutions  for  the  feeble- 
minded in  thirty-one  states.    The  rest  of  this  class  is  confined 
in  almshouses  and  insane  asylums. 

9.  At  the  last  census  there  were  20,73.1  feeble-minded  in 
special  institutions  and  13,238  in  almshouses.    There  are  prob- 
ably no  less  than  300,000  in  the  United  States. 

10.  Great  Britain  reports   1,527  imbeciles  per   1,000,000 
of  population  ;  and  over  50.000  feeble-minded  were  turned  up 
by  the  recent  military  draft  in  America. 

11.  Valuable  as  are  the  Binet  tests,  they  cannot  be  regarded 
as  infallible  in  the  estimation  of  human  intelligence  and  the 
diagnostication  of  feeble-mindedness. 

12.  Feeble-mindedness  is  largely  hereditary,  and  can  thus 
be  effectively  controlled  by  state  regulation. 

13.  The  central  defect  of  the  feeble-minded  is  lack  of  mem- 
ory, deficient  association  of  ideas  —  inability  to  profit  from 
experience  and  reason  from  cause  to  effect. 

14.  The  lower  grades  of   feeble-mindedness  represent  a 


FEEBLE-MINDEDNESS  2$I 

reversal  to  lower  and  primitive  biologic  types;  but,  unfor- 
tunately, their  corresponding  instincts  are  largely  absent. 

15.  Authorities  (Goddard  and  others)  believe  that  not  less 
than   two-thirds   of    feeble-mindedness   in  this   country  is 
hereditary. 

1 6.  Arrested  mental  development  as  a  result  of  scarlet 
fever  or  other  diseases  and  accidents  is  not  transmissible  by 
inheritance. 

17.  When  two  feeble-minded  persons  marry  —  practically 
all  of  the  offspring  are  destined  to  feeble-mindedness. 

1 8.  An  English  authority  (Tredgold)  thinks  that  90  per 
cent  of  mental  defectiveness  is  hereditary. 

19.  The  recent  decline  in  birth-rates  (52  per  cent  in  twenty- 
four  years)  in  this  country  and  England  is  among  the  more 
desirable  classes ;  the  defective  classes  show  no  decrease. 

20.  One  survey  shows  3.7  children  per  family  among  the 
better  classes ;  7.4  among  the  undesirable  citizens. 

21.  The  study  of  numerous  strains  of  defective  stock  shows 
hqw  unfailingly  these  defectives  pour  their  accursed  germ- 
plasm  on  down  through  their  progeny 

22.  Feeble-mindedness  is  the  consummate  curse  of  the 
human  race.     It  means  to  hark  back  to  the  primitive  level 
of  our  prehistoric  ancestors  without  the  compensation  of  their 
instinctive  faculties. 

23.  Much  of  the  world's  criminality,  immorality,  pauper- 
ism, and  drunkenness  is  due  to  inherited  feeble-mindedness. 

24.  Thirty  per  cent  of  the  general  population  are  carriers 
of  this  hereditary  defectiveness;  and  15  per  cent  (the  less 
desirable)  of  the  present  generation  produces  50  per  cent 
of  the  next. 

25.  Each  year  hundreds  of  inmates  of  the  institutions  for 
the  feeble-minded  are  "  discharged  "  for  various  reasons  — 
to  go  out  and  reproduce  their  kind. 

26.  Even  laws  preventing  the  marriage  of  "  discharged  " 
insane  and  feeble-minded  persons  would  not  control  illegiti- 
mate offspring. 

27.  Many  of  the  feeble-minded  are  also  physically  defec- 
tive —  blind,  deaf,  crippled,  deformed,  epileptic,  etc. 

28.  Physicians  are  a  blessing  to  the  present  generation; 
but  they  are  preserving  and  prolonging  the  lives  of  the  de- 


252  RACE  DECADENCE 

f active  classes,  which  are  destined  to  curse  all  future  genera- 
tions, if  nothing  is  done  to  prevent  further  reproduction  of 
these  defective  strains. 

29.  It  is  a  biologic  crime  to  allow  the  manifestly  defective 
and  degenerate  to  reproduce  themselves. 


CHAPTER  XVII 
THE  MORON  PROBLEM 

HAVING  given  consideration  to  the  less  serious  nervous 
disorders,  and,  in  the  preceding  chapter,  considered 
certain  phases  of  feeble-mindedness,  we  must  now  turn  our 
attention  to  the  more  troublesome  and  the  more  dangerous 
element  of  the  whole  feeble-minded  class  —  the  morons  — 
the  more  intelligent  and,  therefore,  more  unsocial  group  of 
defectives  and  delinquents. 

HEREDITY  A  STRONG  FACTOR 

'  In  cases  involving  illegitimate  children,  60  per  cent  of  the 
girls  are  mentally  defective "  —  they  are  largely  morons. 
This  is  an  important  discovery,  as  everyone  realizes  how  often 
adopted  children  go  wrong.  It  upholds  our  theory  that 
heredity  is  the  intrinsic  cause  of  feeble-mindedness,  while 
environment  is  but  an  extrinsic  cause.  Of  the  prostitutes 
examined  in  the  Chicago  Morals  Court,  84  per  cent  were 
found  to  be  subnormal  mentally. 

One  interesting  fact  brought  to  light  was  that  the  lower 
the  mentality  the  earlier  the  boys  get  into  the  toils  of  the  law. 
"  Nearly  all  of  them  are  habitual  cigarette  smokers,  and  a 
small  percentage  use  cocaine  and  morphine." 

Dr.  Hickson  says  that  he  is  more  and  more  convinced  that 
psychopathy  determines  crime  and  that  intelligence  merely 
affects  the  nature  of  it.  Concerning  the  criminal  tendencies 
of  the  defective  this  physician  says :  "  We  are  therefore  able 
to  predict  that  with  the  exception  of  the  lightest  grades  of 
dementia  praecox  and  the  higher  grades  of  the  feeble-minded, 

253 


254  RACE  DECADENCE 

who  make  up  the  occasional  criminal,  that  the  others  are  all 
marked  for  slaughter;  that  they  cannot  adjust  themselves  to 
a  normal  environment." 

Mental  defect! veness  (moronism)  is  hereditary  and  con- 
stitutional, and  consequently  not  amenable  to  our  preachings, 
asylums,  hospitals,  reformatories,  penitentiaries,  etc.  We 
must  ever  bear  in  mind  that  each  year  a  new  quota  of  defec- 
tives is  born  with  statistical  regularity.  They  pass  through 
the  hands  of,  their  parents,  then  the  pedagogues,  the  theo- 
logians, the  physicians,  the  social  workers,  the  employers,  the 
courts,  the  prisons,  and  back  on  society,  each  one  in  turn 
passing  them  up  to  the  next,  and  no  one  willing  to  acknowl- 
edge their  impotency  in  the  face  of  this  plague  of  mental 
defectiveness. 

DEFINITION  OF  MORONISM 

When  we  come  to  study  the  moron  it  will  be  necessary  to 
define  the  term  —  probably  wise  to  define  a  number  of  asso- 
ciated terms  in  this  connection,  so  that  the  reader  may  gain 
an  idea  as  to  just  where  the  moron  comes  in  the  long  scale 
of  nervous  defectives  and  mental  degenerates. 

Dr.  W.  J.  Hickson,  of  Chicago's  Municipal  Court  Psycho- 
pathic Laboratory,  offers  the  following  definitions  of  idiot, 
imbecile,  moron,  and  sociopath: 

1.  Idiot. —  Person  having  mentality  equivalent  to  that  of  a 
I  to  3  year  old  child. 

2.  Imbecile. —  Adult  with  3  to  8  years  mentality. 
5.  Moron. —  Mentality  of  from  8  to  12  years. 

4.  Sociopath. —  Mentality  above  that  of  normal  12  year  old, 
but  so  defective  that  it  is  not  able  to  maintain  individual 
independence. 

This  group  of  subnormal  and  abnormal  persons  —  taken 
as  a  whole,  may  be  called  "  feeble-minded,"  "  half-wits,"  etc., 
and  as  such  have  already  been  discussed  in  the  preceding 


THE  MORON  PROBLEM  255 

chapter,  but  at  this  time  we  desire  to  classify  and  study  the 
morons,  or  sociopaths. 

The  author  would  classify  —  roughly  —  all  subnormal  per- 
sons with  a  mentality  of  8  years  and  above  as  morons,  those 
ranging  from  8  to  12  years  as  "low-grade"  morons,  and 
those  ranging  from  12  years  up  to  nearer  normal  as  "  high- 
grade  "  morons,  or  sociopaths.  It  should  be  remembered  that 
the  simple  feeble-minded  individual  makes  little  trouble  for 
society.  It  is  the  feeble-minded  person  subject  to  emo- 
tional disturbances  at  varying  intervals  who  lapses  into 
vice,  violence,  and  crime. 

MORON  STATISTICS 

It  is  estimated  that  Illinois  has  about  25,000  feeble-minded. 
Of  this  number  only  about  2,000  are  under  proper  supervision 
or  restraint.  Illinois  ranks  twenty-third  among  the  states  in 
its  care  for  morons.  Massachusetts  leads ;  then  come  Ohio, 
Minnesota,  and  Iowa.  There  are  thought  to  be  about  400,000 
of  this  defective  type  in  the  United  States. 

British  statistics  say  that  there  is  one  moron  for  every  217 
people  in  England. 

Between  2.5  and  3  per  cent  of  the  men  examined  for  the 
army  were  of  the  moron  or  feeble-minded  type.  Men  were 
accepted  for  foreign  service  who  measured  mentally  up  to  10 
years,  and  for  domestic  service  up  to  8  years. 

There  are  only  two  remedies  for  these  alarming  conditions, 
isolation  or  segregation,  and  sterilization.  It  is  maintained 
that  the  latter  does  not  prevent  criminal  assaults ;  and  on  the 
whole  segregation  in  supervised  colonies  seems  to  present 
the  ideal  method  of  handling  these  higher  grades  of  feeble- 
mindedness or  moronism,  as  at  least  two-thirds  of  all  these 
cases  are  hereditary.  Isolation  during  the  childbearing  period 
of  all  morons  would  in  thirty-three  years,  I  believe,  practically 
solve  this  problem.  It  is  the  only  thing  to  do,  but  at  present 


256  RACE  DECADENCE 

we  have  no  places  for  such  isolation.     Our  first  business 
should  be  to  provide  such  places. 

Our  present  system  of  handling  morons  and  other  high- 
grade  defectives  and  degenerates  is  highly  extravagant.  Our 
system  of  handling  defective  criminals  is  extremely  costly  in 
both  a  financial  and  a  social  way.  Let  us  take  the  figures 
offered  in  connection  with  the  sentencing  of  1,536  defendants 
to  the  House  of  Correction  in  the  Boys'  Court  of  Chicago. 
This  monetary  expense  is  placed  at  $1,845,600.  This  means 
that  it  actually  costs  about  $1,200  to  send  a  boy  to  the  House 
of  Correction.  Would  it  not  pay  better  to  put  this  money  into 
the  more  scientific  program  of  permanent  isolation  for  these 
defectives  who  are  potential  criminals? 

"  BACKWARDNESS  "  AND  "  DULLNESS    " 

The  out-and-out  moron  must  not  be  confused  with  the 
"  backward  child."  Many  youths  are  "  dull  "  from  physical 
causes  alone.  In  many  cases  it  is  impossible  to  determine 
whether  the  apparent  "  backwardness  "  or  "  dullness  "  is  in- 
herent or  due  to  some  physical  disorder.  With  the  removal 
of  the  physical  conditions,  many  of  these  individuals  will 
show  marked  improvement.  Physical  causes  include  general 
poor  physical  conditions,  overuse  of  narcotics  and  stimulants, 
bad  sex  habits,  arrested  development,  and  epilepsy.  It  should 
be  remembered  that  epilepsy  may  be  associated  with  anything 
from  supernormality  to  idiocy  and  insanity,  and  that  some- 
times an  apparent  mental  defect  may  clear  up  under  success- 
ful treatment  for  this  disease.  Without  a  proper  and  com- 
petent examination,  we  must  not  diagnose  apparent  "  back- 
wardness "  and  "  dullness  "  —  even  stupidity  —  as  moronism. 
Only  those  defective  individuals  who  are  such  from  heredity 
are  to  be  regarded  as  falling  into  the  class  of  morons.  And 
it  should  be  remembered  that  it  is  the  moron  who  constitutes 
the  potential  criminal  class. 


THE  MORON  PROBLEM  257 

CONSTITUTIONAL  INFERIORITY 

Psychic  constitutional  inferiority  may  be  recognized  by  chronic 
abnormal  social  and  mental  reactions  to  the  ordinary  conditions  of 
life,  on  the  part  of  one  who  cannot  be  classified  in  any  of  the  groups 
of  the  insanities,  neuroses,  or  mental  defectives. — Healy. 

The  general  characteristic  of  the  constitutionally  inferior 
is  abnormal  reaction  to  some  of  the  ordinary  stimuli  of  life. 
Unusual  emotional  reactions  are  almost  universal  in  the  mem- 
bers of  this  class.  They  are  often  eccentric,  selfish,  irritable, 
very  suggestible,  and  easily  fatigued.  They  have  a  general 
incapacity  for  doing  things.  They  may  be  slightly  defective 
in  intelligence  or  have  light,  specialized  defects  of  ability,  but 
very  often  tests  reveal  neither  defect  nor  peculiarity.  Indeed 
some  members  of  this  class  may  be  regarded  as  distinctly 
bright,  even  geniuses,  although  weak  in  power  to  meet  the 
steady  demands  of  the  world. 

On  the  functional  side  these  individuals  are  notoriously 
subject  to  "  general  nervousness."  "  Specifically,  we  may  find 
tremors,  facial  or  other  tics  (habit  spasms),  abnormal  move- 
ments of  the  eyes,  headaches,  little  attacks  of  dizziness, 
enuresis,  prolonged  throughout  childhood,  and  so  on."  The 
organs  of  the  special  senses  are  particularly  apt  to  show  signs 
of  inferiority;  defective  vision  is  very  common. 

It  is  undoubtedly  true  that  most  of  these  constitutional  in- 
feriors may  be  regarded  as  degenerates,  but  many  of  the  so- 
called  degenerates  belong  to  other  classes. 

The  treatment  of  the  constitutionally  inferior  resolves 
itself  down  to  very  careful  oversight  and  patient  education, 
particularly  during  the  years  of  adolescence.  Permanent 
colonization  is  needed  for  most  of  them. 

DEMENTIA   PRAECOX 

Of  the  total  number  of  mental  defectives  examined  in 
recent  years  at  the  Psychopathic  Laboratory  of  the  Munici- 


258  RACE  DECADENCE 

pal  Court  of  Chicago,  nearly  700  were  found  to  be  suffer- 
ing from  dementia  praecox.  Few  of  this  group,  according 
to  the  laboratory  findings,  can  be  reformed.  A  specific  study 
of  eighty-five  individual  cases,  in  which  the  defendants  were 
held  to  the  grand  jury  and  later  sent  to  the  Pontiac  Reforma- 
tory from  the  Criminal  Court,  shows  that  all  had  been  former 
offenders  —  some  of  them  having  been  charged  with  twelve 
offenses.  In  one  Pontiac  case  the  boy  defendant  was  indicted 
on  twenty-three  holdup  and  larceny  charges.  He  was  of 
average  intelligence,  with  the  exception  of  having  dementia 
praecox. 

Dementia  praecox  is  really  a  form  of  insanity  —  usually 
making  its  appearance  around  the  time  of  adolescence;  but 
also  showing  up  sometimes  at  a  later  time  in  life.  The  dis- 
ease takes  on  various  forms,  and  the  evidences  of  actual 
insanity  may  not  be  plain  at  first.  The  early  signs  of  this 
disorder  which  bring  individuals  suffering  from  it  so  fre- 
quently to  the  notice  of  police  officials,  visiting  nurses,  social 
workers,  etc.,  are  often  those  of  extreme  shyness  and  fear. 
Sufferers  are  almost  always  males.  The  young  man  dislikes 
to  go  out-of-doors,  or  meet  strangers.  He  will  not  look  for  a 
job  —  he  shrinks  from  meeting  a  prospective  employer.  He 
seems  utterly  ashamed  of  himself  and  his  own  shortcom- 
ings, and  may  hide  even  from  his  own  family.  They  often 
resort  to  violence  when  coercion  is  attempted.  Variations  in 
the  form  of  excitement,  together  with  utter  dullness,  may 
appear  during  the  course  of  this  disease. 

One  feature  of  importance  in  the  evolution  of  this  disease 
is  the  practice  of  masturbation.  With  astonishing  frequency 
cases  of  dementia  praecox  indulge  excessively  in  bad  sex 
habits.  This  is  so  noticeable  that  it  is  often  difficult  to  con- 
vince parents  that  the  disease  itself  is  not  caused  by  this 
practice.  The  idea  of  suicide  is  frequently  entertained  in 
cases  of  dementia  praecox. 


THE  MORON  PROBLEM  259 

PROPOSED    MORON    COLONY 

All  experts  in  juvenile  crime  are  agreed  that  the  ordinary 
processes  of  criminal  prosecution  are  not  applicable  to  these 
mentally  subnormal  offenders.  They  are  equally  agreed  that 
the  state-managed  colony  or  farm  is  the  ideal  method  of  han- 
dling these  defectives.  Such  a  colony  would  not  only  mate- 
rially reduce  crime  but  would  also  reduce  the  police  force 
of  any  great  city,  thus  benefiting  from  such  an  arrangement, 
to  such  an  extent  as  to  contribute  an  enormous  sum  annually 
toward  creating  and  maintaining  such  a  farm-colony  for 
these  defectives. 

In  such  a  colony  these  morons  and  other  subnormals  would 
be  60  to  70  per  cent  efficient,  and  the  institution  would  be  at 
least  two-thirds  self-supporting.  It  is  much  more  costly  to 
have  these  fellows  around  loose,  holding  people  up,  break- 
ing Into  stores,  and  attacking  young  girls.  They  have  the 
minds  of  10  to  12  year  old  children,  and  all  the  instincts  of 
adults.  "  They  have  no  insight  or  foresight,  and  they  try  to 
provide  for  themselves  by  direct  means,  whereas  we  —  the 
average  or  normal  individuals  —  adopt  more  roundabout 
methods  of  making  a  living,  as  someone  has  said, '  We  are  the 
more  clever  criminals.' ' 

The  laws  should  be  changed.  Under  the  German  code, 
if  mental  disease  is  proven,  there  is  no  criminal  deed  com- 
mitted. The  judge  turns  the  prisoner  over  to  the  psychiatrist. 
It  means  a  big  saving  in  the  machinery  of  the  law  and  saves 
the  befuddling  of  the  juries  by  so-called  "  expert  "testimony. 

"A  moron  can  never  safely  live  in  a  community.  They 
must  be  isolated,  segregated,  and  under  constant  supervision. 
We  have  in  this  country  excellent  commitment  laws  based  on 
the  English  code,  but  there  is  no  provision  made  for  places  to 
commit  them." 

We  believe  that  the  most  important  legislation  now  pending 


260  RACE  DECADENCE 

in  this  country  is  to  provide  adequate  farm-colonies  for  these 
moron  defectives,  as  some  states  have  begun  to  provide  the 
long-needed  epileptic  colonies. 

THE  "  FEEBLY  INHIBITED  " 

While  many  of  the  victims  of  violent  temper  —  those  in- 
dividuals who  greatly  lack  in  self-control  —  may  belong  to 
the  moron  class,  at  the  same  time,  we  are  forced  to  recognize 
that  many  of  these  badly  controlled  persons  are  not  definitely 
feeble-minded.  Davenport  and  his  associates  have  shown,  by 
painstaking  investigation,  that  many  of  these  turbulent  per- 
sons belong  to  the  "  feebly  inhibited "  type  —  a  group 
which  directly  inherits  its  tendency,  but  which,  on  the  whole, 
is  not  markedly  defective,  from  a  standpoint  of  general  in- 
telligence. The  disposition  to  wander  away  from  home, 
manifested  by  some  children,  the  tramping  or  nomadic  in- 
stinct which  characterizes  many  individuals  —  not  to  mention 
races  —  together  with  many  other  subnormal  tendencies,  are 
found,  on  careful  investigation,  to  be  the  result  of  the 
hereditary  absence  of  certain  factors  which  enable  the  nor- 
mal individual  to  inhibit,  control,  and  suppress  many  of  these 
instinctive  nomadic  or  violent  temperamental  tendencies. 
And  there  can  be  little  doubt  that  the  American  population 
is  becoming  saturated  with  an  increasing  number  of  these 
mildly  abnormal  individuals,  who,  taken  as  a  class,  belong  to 
this  group  of  the  so-called  "  feebly  inhibited,"  and  we  have 
every  reason  to  believe  that,  in  common  with  the  other  and 
serious  forms  of  defectiveness  and  degeneracy,  these  milder 
and  less  violently  anti-social  groups  are  increasingly  appear- 
ing in  our  population  at  the  present  time. 

SUMMARY   OF   THE   CHAPTER 

I.  To  society,  the  morons  represent  the  more  dangerous 
element  of  all  classes  of  defectives  and  degenerates. 


THE  MORON  PROBLEM  261 

2.  In  the  case  of  girls  having  illegitimate  children,  60  per 
cent  are  mentally  defective  — morons.     This  may  explain 
why  so  many  of  these  adopted  children  go  wrong.    ' 

3.  Psychopathy    largely    determines    crime  —  intelligence 
merely  affects  the  nature  and  extent  of  it. 

4.  Moronism  is  hereditary  and  therefore  constitutional.    It 
is  not  going  to  be  influenced  by  preaching,   asylums,   or 
reformatories. 

5.  It  should  be  remembered  that  the  moron  possesses  a 
mentality  ranging  from  8  years  up  to  12.     Those  from  12 
years  up    (but  not  normal)    are  sometimes  called  "  high- 
grade  "  morons. 

6.  Of  25,000   feeble-minded  in   Illinois,  only  2,000  are 
under  restraint.    There  are  probably  400,000  morons  in  the 
United  States;  one  moron  for  every  217  population  in  Eng- 
land. 

7.  Three  per  cent  of  those  examined  for  the  army  belong 
to  the  morons  or  similarly  defective  type ;  and  two-thirds  of 
these  cases  are  hereditary. 

8.  It  actually  costs  the  city  of  Chicago  $1,200  to  send  a 
moron  to  the  House  of  Correction.     How  long  will  it  take 
us  to  find  a  better  way  to  handle  these  defectives? 

9.  The  moron  must  not  be  confused  with  the  "  back- 
ward "  child,  nor  with  those  who  are  just  "  dull  "  from  tem- 
peramental or  physical  causes. 

10.  Some  cases  are  difficult  to  classify  and  are  put  into 
a    group    called    "  constitutionally    inferior."     They    are 
chiefly  emotional  and  nervous. 

11.  Dementia  praecox  is  really  a  form  of  insanity,  making 
its  appearance  around  adolescence.     It  predominates  among 
males. 

12.  Praecox  patients  are  usually  shy,  unsocial,  shirk  re- 
sponsibility, masturbate,  and  often    resort    to    violence  if 
coerced. 

13.  The  ideal  method  of  caring   for  morons  would  be 
a  properly  conducted  farm-colony,  where  these  social  mis- 
fits could  be  60  per  cent  efficient  and  self-supporting. 

14.  A  moron  can  never  safely  live  in  a  civilized  commu- 
nity.    Money  and  lives  could  both  be  saved  if  these  defec- 
tives were  sanely  and  scientifically  handled. 


262  RACE  DECADENCE 

15.  In  addition  to  morons,   we  have  a  vast  group  of 
"  feebly  inhibited  "  individuals,  embracing  the  nomadic  type 
and  the  little-controlled  temperamental  group. 

16.  The  American   population   is   becoming   increasingly 
saturated  with  these  various   sorts  of   defectives  and  de- 
generates. 


CHAPTER  XVIII 
EPILEPSY  AND  SEX  PERVERSION 

WE  ENCOUNTER  numerous  cases  difficult  of  classi- 
fication in  our  study  of  mental  defectiveness  and  its 
relations  to  society.     Epilepsy  is  a  fairly  definite  disease, 
but  the  various  groups  of  sex  perverts  are  much  more  diffi- 
cult of  either  understanding  or  classification. 

THE  EPILEPTIC  PROBLEM 

It  has  been  calculated  that  the  number  of  epileptics  in  the 
state  of  New  Jersey,  where  the  most  careful  investigation  of 
the  problem  has  been  made,  will  double  every  thirty  years 
under  present  conditions. 

"  In  dealing  with  both  insanity  and  epilepsy,  the  eugenist 
faces  the  difficulty  that  occasionally  people  of  the  very  kind 
whose  production  he  most  wishes  to  see  encouraged  —  real 
geniuses  —  may  carry  the  taint." 

It  is  doubtful  if  we  can  always  regard  epileptics  as  we 
do  the  feeble-minded  and  advocate  the  application  of  general 
and  universal  restrictive  measures  to  reproduction.  The 
exaggerated  claims  of  the  Italian  anthropologist,  C.  Lom- 
broso,  and  his  school,  in  regard  to  the  close  relation  between 
genius  and  insanity,  have  been  largely  disproved;  yet  there 
remains  little  doubt  that  the  two  sometimes  do  go  together ; 
and  such  supposed  epileptics  as  Mohammed,  Julius  Caesar, 
and  Napoleon  will  at  once  be  called  to  mind.  To  apply 
sweeping  restrictive  measures  would  prevent  the  production 
of  a  certain  amount  of  talent  of  a  very  high  order. 

A  field  survey  in  two  typical  counties  of  Indiana  showed 

263 


264  RACE  DECADENCE 

that  there  were  1.8  recognizable  epileptics  per  1,000  popula- 
tion. 

If  these  figures  should  approximately  hold  good  for  the 
entire  United  States,  the  number  of  epileptics  can  hardly  be 
put  at  less  than  150,000.  Some  of  them  are  not  antisocial, 
but  many  of  them  are. 

Feeble-mindedness  and  insanity  were  also  included  in  the 
census  mentioned,  and  the  total  number  of  the  three  kinds  of 
defectives  was  found  to  be  19  per  1,000  in  one  county  and 
11.4  per  1,000  in  the  other.  This  would  suggest  a  total 
for  the  entire  United  States  of  something  like  1,000,000. 

As  a  result  of  the  recent  study  of  an  entire  epileptic  colony, 
it  appeared  that  about  85  per  cent  of  the  inmates  were 
feeble-minded  from  the  standpoint  of  intelligence,  and  that 
the  great  majority  (61.5  per  cent)  were  classified  as  high- 
grade  morons. 

In  view  of  the  above  facts,  namely,  the  obscure  nature  of 
the  affection,  its  incurability,  and  its  permanent  psycho- 
pathic, psychasthenic,  and  sociapathic  sequelae,  we  can  hardly 
agree  with  Binet  and  Simon  that  the  problem  of  epilepsy  — 
at  least  in  the  present  unsatisfactory  state  of  its  therapy  — 
"  is  essentially  medical."  Tanzi,  according  to  our  views,  has 
stated  the  situation  more  fairly :  "  Epileptics  require  not 
only  medical  treatment  but  also,  and  perhaps  even  more, 
care  and  supervision."  (See  Fig.  15.)  While,  therefore, 
I  do  not  wish  to  minimize  the  value  of  the  medical  care  and 
supervision  of  the  epileptic  by  the  skilled  epileptologist,  in 
fact,  I  deem  such  supervision  absolutely  essential  so  long  as 
the  epileptic  continues  to  suffer  from  severe  or  frequent 
repeated  convulsions,  it  is  clear  that  "  society  will  not  do  its 
duty  by  the  individual  epileptic  until  it  provides  him  with  the 
type  of  educational  and  social  training  and  care  which  will 
tend  to  make  him  maximally  self-supporting,  and  until  it  sup- 
plies the  form  of  benevolent  restraint  and  occupational  pro- 


EPILEPSY  AND  SEX  PERVERSION  265 

visions  which  are  necessary  both  in  the  interest  of  the  well- 
being  of  the  persons  afflicted  and  the  welfare  of  society." 

EPILEPSY  AND   HEREDITY 

Epilepsy  is  a  term  believed  by  many  physicians  to  cover 
a  number  of  distinct  brain  disorders  that  have  in  common 
the  symptom  known  as  convulsions,  or  "  fits." 

The  heredity  basis  of  epilepsy  has  been  carefully  studied 
and,  almost  without  exception,  it  follows  the  same  general 
laws  as  feeble-mindedness.  Two  epileptic  parents  probably 
produce  only  defective  offspring,  the  defect  sometimes  taking 
the  form  of  epilepsy,  sometimes  that  of  feeble-mindedness. 
It  does  not  seem  necessary  to  repeat  the  laws  of  heredity  for 
epilepsy,  since  in  them  the  words  of  epilepsy  and  feeble- 
mindedness are  almost  interchangeable.  The  epilepsies 
which  are  not  inherited  are  probably  not  true  epilepsy  — 
but  rather  pseudo-epilepsy  or  some  other  form  of  convulsive 
seizures  which  are  so  often  erroneously  called  epilepsy. 
The  hereditary  nature  of  most  types  of  genuine  epilepsy  is 
now  generally  recognized. 

A  STUDY  OF  EPILEPSY  IN  NEW  YORK 

The  New  York  State  Board  of  Charities  recently  pub- 
lished a  bulletin  regarding  the  Craig  colony.  In  this  colony 
there  are  1,500  epileptics.  They  investigated  nine  families  in 
which  there  was  an  unusual  amount  of  epilepsy.  In  these 
nine  families  there  were  200  individuals  into  whose  history 
and  habits  inquiry  was  made.  Of  these  63  were  found  to  be 
feeble-minded.  Some  of  the  conclusions  to  be  found  in  the 
study  are  as  follows : 

Inheritance  plays  an  important  part  in  epilepsy.  Cowers 
estimated  that  to  it  was  due  40  per  cent  of  the  total  influences 
causing  the  disease.  Kraeplin  made  an  estimate  of  75  per 
cent.  The  difference  was  due  to  the  fact  that  Kraeplin  took 


266  RACE  DECADENCE 

into  account  more  mental  and  nervous  states  than  did  Cowers. 

In  this  study  there  was  a  history  of  chronic  alcoholism  in 
at  least  one  parent  or  grandparent  in  one-third  of  the  cases, 
a  history  of  epilepsy  in  one  parent  or  grandparent  in  one- 
fifth  of  the  cases,  and  a  history  of  insanity  in  one-tenth. 

Dr.  W.  A.  Evans  in  summarizing  this  investigation  says: 

It  was  shown  that  where  there  were  the  weak  traits  of  a  poor 
stock  in  families  where  there  was  epilepsy  those  traits  were  em- 
phasized. If  two  neuropathic,  neurotic  individuals  married  there 
was  a  much  more  than  average  possibility  that  some  of  the  progeny 
would  have  epilepsy.  The  conditions  of  mental  and  nervous  weak- 
ness and  instability  out  of  which  epilepsy  grew  and  which  were 
liable  to  grow  out  of  epilepsy  were :  insanity,  alcoholism,  the  estab- 
lished migraine  habit,  and  various  convulsive  disorders.  If  in  a 
family  tree  there  was  any  undue  amount  of  any  of  these  disorders 
there  was  likely  to  be  an  unusual  amount  of  epilepsy  also. 

Of  the  cases  of  epilepsy  investigated  74  to  85  per  cent  de- 
veloped before  20  years  of  age  and  of  this  group  one-half 
developed  before  5  years  of  age.  Doctors  divide  epilep- 
tics into  three  groups.  First,  the  cases  which  develop  early. 
In  this  group  inheritance  is  a  considerable  factor.  Second, 
adolescents;  and  third,  epilepsy  first  developing  late  in  life. 
The  disease  among  those  of  the  third  group  is  frequently 
associated  with  a  history  of  alcoholism,  syphilis,  and  arterio- 
sclerosis. In  one-fourth  of  the  cases  of  epilepsy  investigated 
there  was  a  history  of  injury  at  the  time  of  birth. 

The  estimate  was  made  that  there  are  175,000  epileptics  in 
the  United  States,  6,860  being  registered  in  New  York  City. 

SEX  PERVERTS 

No  discussion  of  f  eeble-mindedness,  moronism,  etc.,  would 
be  complete  without  some  consideration  being  given  to  the 
question  of  sexual  perversions.  There  is  no  way  of  knowing 
what  percentage  of  our  population  is  abnormal  in  this  re- 
spect, but  the  frequent  crimes  that  are  committed  against 


EPILEPSY  AND  SEX  PERVERSION  267 

young  boys,  pointing  to  perversions  more  or  less  homo- 
sexual in  their  nature ;  and  the  terrible  outrages  perpetrated 
every  now  and  then  against  little  girls,  showing  perverted 
sex  leanings  along  other  lines,  all  serve  to  indicate  that  there 
is  no  inconsiderable  number  of  these  abnormally  sexed  indi- 
viduals to  be  found  in  the  general  population. 

These  sex  perverts  cannot  always  be  regarded  as  belong- 
ing to  the  feeble-minded  or  moron  group.  They  are  some- 
times quite  thoroughly  normal  mentally,  when  subjected  to 
every  possible  test,  and  only  show  their  abnormality  or  de- 
generacy when  it  comes  to  the  matter  of  sex  behavior  and 
sex  relations. 

No  doubt  many  of  the  sex  crimes  that  shock  modern 
society  from  time  to  time  are  committed  by  those  who  are 
mentally  defective,  by  morons,  and  even  in  some  cases  by 
higfi-grade  imbeciles  or  idiots.  But  on  the  whole,  these  sex 
crimes  are  committed  by  a  different  group  of  abnormal  indi- 
viduals, by  a  class  of  defectives  who  may  be  said  to  belong 
to  and  constitute  the  "  third  sex,"  in  that  they  are  so  thor- 
oughly abnormal  that  they  can  scarcely  be  classed  sexually 
as  either  typical  males  or  females. 

While  habitual  obscenity  of  thought  and  long-continued 
bad  sex  practices  may  sometimes  lead  up  to  some  form  of 
sex  perversion;  nevertheless  we  think,  as  a  general  rule, 
these  cases  are  more  largely  hereditary.  In  the  case  of  these 
homosexual  perverts,  it  would  seem  that  an  individual  may 
6e  born  with  a  man's  body  but,  sexually  speaking,  with  a 
woman's  brain.  They,  therefore,  develop  sex  affection  for 
those  of  their  own  physical  sex.  Mild  sex  perversion  of  this 
sort  can  be  acquired  and  is  not  always  hereditary,  and  in 
these  cases  it  is  more  or  less  curable.  Many  of  our  tramps 
are  sex  perverts  of  the  homosexual  order. 

It  is  the  author's  opinion  that  the  sex  perverts  who  perpe- 
trate the  most  of  our  outrageous  crimes  of  this  nature  are  a 


268  .RACE  DECADENCE 

class  belonging  to  the  feeble-minded  group  as  a  whole,  and 
who  have  directly  inherited  their  brutal  and  perverted  sex 
tendencies.  It  is  certain  that  this  unfortunate  group,  as  a 
class,  is  much  more  numerous  than  we  are  willing  to  believe. 
One  thing  is  certain,  men,  in  particular,  who  are  once  con- 
victed of  a  crime  of  this  kind,  should  not  be  turned  loose  to 
prey  upon  innocent  childhood.  They  should  be  segregated  or 
otherwise  so  confined  in  some  special  colony  as  to  render 
them  incapable  of  further  mischief,  for  in  most  cases  of  this 
sort,  once  a  sex  pervert,  always  a  sex  pervert. 

ABNORMAL  SEXUALISM 

We  are  frequently  at  a  loss  to  decide  what  mainly  under- 
lies any  appearance  of  abnormal  sexualism  in  a  certain  indi- 
vidual, or  at  least  to  decide  in  what  proportion  various 
possible  causes  may  have  been  operative.  Who  can  tell 
whether  the  person  who  exhibits  antisocial  sexual  tendencies 
is  the  victim  of  an  excessive  output  from  internally  secreting 
glands,  or  of  obsessive  mental  imagery,  or  of  predisposing 
anatomical  conditions,  or  of  various  environmental  and  phys- 
ical experiences  ?  Frequently  still  more  difficult  is  it  to  decide 
between  innate  tendencies  as  a  whole,  some  of  which  may  be 
derived  from  heredity,  and  others  from  the  effect  of  environ- 
ment. 

The  overwhelming  attraction  which  Negro  men  occasion- 
ally have  for  white  girls  and  women,  directly  leading  in  our 
social  life  to  delinquency,  is  to  be  explained  by  the  hyper-sex- 
ualism  of  the  female  attracted.  One  has  seen  instances  in 
which  the  arguments  of  social  ostracism,  race  antipathy,  and 
religious  faith  have  availed  nothing  against  this  extraordi- 
nary impulse. 

Dr.  William  Healy  remarks  that : 

Undoubtedly  hyper-sexualism  is  a  vastly  greater  cause  in  early 
life  of  other  than  sex  offenses  than  it  is  later.  The  morally  dis- 


EPILEPSY  AND  SEX  PERVERSION  269 

turbing  influence  would  naturally  be  much  more4  during  the  years 
when  there  is  less  than  normal  adult  self-control.  Mere  repression, 
such  as  is  undertaken  in  all  sorts  of  penal  institutions,  frequently 
turns  the  individual  from  seeking  one  kind  of  gratification  to  an- 
other that  may  be  more  disastrous  mentally.  Punishment  does  not 
destroy  in  these  sexualistic  individuals  such  deep-set  mental  and 
physical  inclinations. 

The  theft  of  articles  for  fetishism,  that  is  for  their  sex- 
ually symbolic  purposes,  is  well  known. 

The  remarkable  self -abnegating  impulse  which  leads 
women  to  become  the  abject  slaves  of  men,  even  to  the  extent 
of  turning  over  earnings  gained  from  sex  immorality,  is  of 
a  sexualistic  origin.  The  power  of  the  "  cadet  "  over  women 
cannot  be  understood  unless  this  psychological  phase  of  their 
relationship  is  taken  into  account.  Some  women  find  satis- 
faction in  actually  suffering  at  the  hands  of  their  masters. 
This  subjection  directly  gives  opportunity  for  development  of 
sexual  vice. 

"  The  impulse  to  peculiarly  violate  little  girls,  often  with- 
out rape,  is  one  which  unfortunately  is  not  infrequently  met 
with  in  court  work.  At  the  risk  of  discovery  and  imprison- 
ment the  offense  may  be  repeated  over  and  over,  and  in  this 
shows  the  force  of  an  obsessional  impulse." 

MASTURBATION 

We  decry  exaggeration  on  this  subject  because  in  some 
ways  the  habit,  like  other  single  factors,  is  not  nearly  so  im- 
portant as  has  been  represented.  Then,  too,  our  experience 
in  dealing  with  a  large  number  of  nervous  patients,  shows  us 
the  truth  of  what  has  frequently  been  observed,  namely,  that 
worry  about  masturbation  frequently  does  more  harm  than 
the  habit  itself.  On  the  other  hand,  Healy  in  his  study  of 
young  offenders  who  were  well  started  in  careers  of  delin- 
quency, was  profoundly  impressed  with  the  breakdown  of 
will,  of  physical  condition,  and  of  general  moral  fiber  that  is 


270  RACE  DECADENCE 

correlated  with  the  excessive  practice  of  masturbation.  He 
regarded  it  as  of  the  utmost  importance  as  a  causative  factor 
in  girls  as  well  as  in  boys.  The  extent  to  which  it  stands  out 
clearly  may  be  seen  by  his  statistics.  In  over  10  per  cent  the 
habit  was  practiced  to  such  a  degree  that  it  was  to  be  fairly 
considered  a  definite  cause.  In  many  other  instances  the 
practice  may  have  been  a  habit,  but  they  did  not  learn  that  it 
was  anything  of  a  factor  in  producing  delinquency.  Healy 
further  says : 

The  connection  between  masturbation  and  antisocial  offenses 
seems  to  be  established  along  the  following  lines  —  the  effect 
varying  greatly,  of  course,  with  environmental  circumstances  and 
innate  tendencies  of  the  individual.  The  act  in  itself  is  antisocial. 
The  individual  feels  this,  and  realizes  the  stigma  which  indulgence 
places  upon  him.  His  constant  efforts  at  secrecy  in  this  regard  may 
lead  to  moral  breakdown.  The  sequence  is  not  difficult  to  under- 
stand. First  there  is  weak  self-indulgence,  then  secretiveness  and 
lies,  then  avoidance  of  duties  and  search  for  stimulation  and  arti- 
ficial energy.  The  effect  of  masturbation  in  directly  promoting 
several  forms  of  antisocial  behavior  among  young  people  is  one  of 
the  most  marked  phenomena  to  be  observed  in  court  work. 

It  should  be  noted  that  at  least  13  per  cent  of  delinquents 
in  Chicago  courts  had  encountered  some  early  sex  experience 
sufficiently  serious  to  be  regarded  by  the  psychologic  experts 
as  a  causative  factor  of  delinquency.  In  these  cases  the  trou- 
ble arose  from  the  teachings  of  other  children  and  adults  of 
both  sexes,  as  much  as  from  actual  bad  sex  practices  with 
others.  In  children  the  unfortunate  introduction  into  sex 
life  came  often  from  persons  of  the  same  sex. 

SUMMARY  OF  THE  CHAPTER 

1.  It  has  been  calculated  (in  New  Jersey)  that  the  num- 
ber of  epileptics  will  double  every  thirty  years  under  present 
methods  and  conditions. 

2.  Epilepsy  is  usually  associated  with  mental  defective- 
ness  :  but  not  always.    It  is  sometimes  connected  with  genius 
—  as  shown  in  Mohammed,  Caesar,  and  Napoleon. 


EPILEPSY  AND  SEX  PERVERSION  271 

3.  A  survey  of  Indiana  showed  almost  2  epileptics  per 
1,000  of  population.    This  would  mean  about  150,000  for  the 
whole  country. 

4.  A  study  of  one  colony  showed  85   per  cent   feeble- 
minded;  61.5  per  cent  being  classified  as  high-grade  morons. 

5.  Epileptics  require  colonization,  supervision,  and  proper 
medical    treatment,   together   with   suitable   education   and 
training. 

6.  Epilepsy  is  more  of  a  symptom  complex  than  a  dis- 
ease.   But  whatever  its  protean  character,  it  is  largely  hered- 
itary. 

7.  A  study  of  the  Craig  colony  shows  in  the  ancestors: 
feeble-mindedness,    epilepsy,   alcoholism,    neuroticism,   and 
migraine. 

8.  Three-fourths  of  epilepsy  develops  befort  20  years; 
and  one-half  of  this  before  5  years  of  age. 

9.  There  are  6,860  known  cases  in  New  York  City.    This 
would  mean  175,000  in  the  country. 

10.  Sex  perverts  do    not   always    belong    to  the  feeble- 
minded group.    Many  are  normal  as  regards  all  nonsex  mat- 
ters. 

11.  Some  sex  perverts  are  homosexual  from  birth;  they 
belong  to  the  so-called  "  third  sex  "  —  they  are  physically  of 
one  sex,  while  mentally  belonging  to  the  opposite  sex. 

12.  While  bad  and  unnatural  sex  practices  may  lead  to  sex 
perversion,  nevertheless,  most  of  these  cases   (homosexual 
ones)  are  predisposed  to  their  vice  by  inheritance. 

13.  Out-and-out   sex   perverts   when   once   convicted   of 
crime  against  children,  should  not  be  turned  loose  further  to 
prey  upon  the  innocent. 

14.  Hyper-sexualism  is  responsible  for  many  criminal  as- 
saults, delinquency,  and  vice.    This  is  the  explanation  of  the 
nefarious  "  cadet  "  system. 

15.  Masturbation,  while  associated  with  some  phases  of 
delinquency  is  probably  more  often  an  effect  than  a  cause. 
Its  influence  has  undoubtedly  been  greatly  overestimated. 

16.  Thirteen  per  cent  of  the  delinquents  in  Chicago  courts 
have  encountered  some  early  and  unfortunate  sex  experi- 
ence, sufficiently  serious  to  be  considered  a  factor  in  their 
delinquency. 


CHAPTER  XIX 
THE  BACKWARD  CHILD 

IN  THE  discussion  of  feeble-mindedness  from  time  to  time 
allusion  has  been  made  to  the  backward  child  —  those  cases 
which  are  not  distinctly  defective,  but  which  are  not  strictly 
up  to  average  par.  Let  us  now  give  more  definite  attention 
to  this  large  and  growing  class  of  youngsters  in  our  public 
schools. 

THE  BACKWARD  CHILD  AT  SCHOOL 

Two  per  cent  of  the  pupils  in  the  schools  of  Chicago  are 
mentally  defective,  according  to  Dr.  W.  J.  Hickson  of  the 
Municipal  Court  Psychopathic  Laboratory.  The  teacher  is 
often  handicapped  at  the  start  in  her  efforts  to  develop  good 
character  in  the  pupils  because  of  their  defective  mentality. 

In  most  large  cities  at  the  present  time  special  provision  is 
being  made  for  examining  and  instructing  the  backward 
child.  (See  Fig.  16.)  Special  classes  are  provided  and,  in 
many  instances,  manual  training  is  arranged  for  those  youths 
who  cannot  get  along  with  their  intellectual  studies  but  who 
show  promise  of  responding  to  efforts  along  the  line  of  some 
vocational  training  which  would  prepare  them  to  become 
self-sustaining. 

Dr.  Gould  thinks  there  is  a  direct  relation  between  eye 
troubles,  eyestrain,  etc.,  and  some  phases  of  backwardness  in 
school  children.  Gould  asserts  that : 

Of  late,  it  has  been  clearly  seen  that  civilization  multiplies  enor- 
mously the  causes  of  eyestrain,  and  that  as  a  result  nervous  and 
mental  diseases  are  rapidly  increasing  with  a  frightful  growth  in  the 

272 


THE  BACKWARD  CHILD  273 

general  morbidity  rates.  Suicide  of  children  and  also  of  adults  in 
all  countries  is  in  exact  proportion  to  the  number  of  hours  of  study 
per  week  demanded  of  school  children. 

According  to  a  bulletin  of  the  United  States  Bureau  of  Ed- 
ucation, 25  per  cent,  or  about  5,000,000,  of  the  school  children 
of  our  country  have  defective  vision,  and  about  75  per  cent, 
or  about  15,000,000,  of  the  school  children  in  this  country 
need  attention  today  for  physical  defects  which  are  preju- 
dicial to  health  and  which  are  partially  or  completely  remedi- 
able. 

The  work  of  Dr.  Richards  in  New  York  City  goes  far 
towards  confirming  Dr.  Gould's  contention.  The  former  took 
thirty-eight  backward  children,  finding  thirty-five  of  them 
needing  glasses  badly.  After  about  six  months'  use  of  prop- 
erly fitted  glasses  the  teachers  of  these  children  rendered  re- 
ports of  progress  which  may  be  summarized  as  follows : 

/Jmong  twenty-five  deficient  children  from  regular  classes, 
nineteen  were  promoted. 

Among  nine  children  from  the  ungraded  classes  one  was 
promoted  to  a  regular  class. 

An  examination  of  the  charts  will  show  marked  improve- 
ment in  reading,  arithmetic,  spelling,  and  penmanship.  The 
very  marked  improvement  in  temper,  irritability,  and  power 
of  concentration  is  a  significant  revelation. 

In  the  regular  classes  the  number  of  those  receiving  spe- 
cially pronounced  benefit  in  the  grammar  grades  is  eight ;  of 
those  in  the  primary  grades,  four. 

The  extraordinary  results,  markedly  pronounced  in  so 
many  cases,  justify  the  hope  that  many  similar  experiments 
will  be  made.  The  benefit  derived  by  these  children  has  been 
so  great  and  of  such  a  nature  as  not  to  be  definitely  measur- 
able. 

Dr.  Richards  estimates  that  there  are  about  78,000  chil- 
dren with  defective  vision  in  the  public  schools  of  New  York 


274  RACE  DECADENCE 

and  that  there  is  no  valid  excuse  for  the  failure  to  prevent 
this  evil  in  80  per  cent  of  all  such  patients.  They  are  not 
prevented  now,  he  thinks,  because  the  principles  and  practice 
of  refraction  are  not  adequately  and  correctly  taught  in  med- 
ical colleges.  He  believes  that  in  New  York  there  is  a  di- 
vided responsibility  in  the  government  of  the  schools ;  that  a 
cycloplegic  is  not  used  to  diagnose  the  errors  of  refraction 
in  the'  84  per  cent  of  far-sighted  defectives,  and  that  small 
errors  are  ignored  although  they  have  great  influence  in  de- 
termining effort,  proficiency,  and  conduct.  The  result  is  that 
the  accurate  measure  of  the  refractive  errors  of  the  school 
children  of  the  city  is  impossible,  and,  moreover,  if  it  were 
done  it  would  be  impossible  to  get  the  requisite  spectacles 
made,  adjusted,  and  paid  for.  Lastly,  diagnosis  and  treat- 
ment of  defects  and  diseases  of  other  organs  than  the  eyes  is 
not,  by  any  means,  at  present  feasible. 

PHYSICAL  DEFECTS  IN  SCHOOL  CHILDREN 

Health  department  officials  are  becoming  alarmed  over  dis- 
closures made  through  a  survey  of  eye,  ear,  nose,  and  throat 
defects  in  the  school  children  of  Chicago.  A  surprisingly 
large  number  of  children  have  infected  tonsils,  adenoids,  etc. 

The  conditions  discovered  are  amazing  and  the  parents  are 
in  a  measure  to  blame,  for  they  do  not  grasp  the  importance 
and  danger  of  defects  of  this  kind.  In  many  cases  the  child's 
life  or  health  is  at  stake. 

For  the  purposes  of  a  recent  Chicago  school  survey  differ- 
ent schools  were  classed  according  to  neighborhoods.  The 
defects  were  classified  in  three  groups :  "  deviations  from 
normal  without  symptoms,"  "  deviations  from  normal  with 
symptoms,"  and  "  exaggerated  cases."  A  total  of  86,000 
boys  and  girls  were  examined  among  Chicago's  450,000 
school  children.  The  following  is  a  summary  of  the  statis- 
tics: 


c. 
< 


be 

£ 


THE  BACKWARD  CHILD  2?$ 

No.  of 
Defect  Children 

Defective  vision  only 1 1,973 

Diseases  of  the  eyes,  not  including  defective  vision  2,191 

Defective   hearing    only 1,263 

Ear  discharges  663 

Enlarged  tonsils    29,642 

Defective  nasal  breathing 6,214 

Adenoids    14,262 

Tonsils  and  adenoids  combined 14,044 

The  health  department  physicians  found  an  unusually 
large  number  of  "  exaggerated  cases."  There  were  1,663  m 
this  class  who  had  defective  vision  and  1,559  wno  nac^ 
enlarged  tonsils.  In  the  less  congested  sections  of  the  city 
conditions  were  found  to  be  noticeably  better  than  in  other 
localities. 

The  burden  of  blame  for  the  16,000,000  physically  defec- 
tive children  in  the  public  schools  of  the  country  and  the  lack 
of  teachers  to  man  35,000  of  the  schools  was  placed  on  the 
shoulders  of  the  federal  government  and  the  taxpayers  by 
Thomas  D.  Wood  at  a  recent  convention  of  the  National  Ed- 
ucational Association,  who  declared  that:  "  Of  the  21,000,000 
children  in  the  public  schools,  16,000,000  are  suffering  from 
defects  detrimental  to  their  health  and  education." 

Wood  deplored  the  expenditure  of  vast  amounts  of  money 
in  "  safeguarding  hogs  and  cattle,  with  little  set  aside  for 
keeping  the  children  in  good  physical  repair."  He  advocated 
a  system  of  universal  compulsory  health  and  physical  care. 

In  some  cases  defective  mental  capacity  is  found  in  the 
same  individual  with  acquired  physical  conditions  which 
may  be  reasonably  considered  as  a  possible  cause  for  the 
mental  troubles. 

Some  authorities  believe  that  mental  dullness  or  inefficiency 
may  be  produced  by  excessive  indulgence  in  bad  sex  habits. 
The  effect  sometimes  is  so  marked  that  the  individual  in  ap- 
pearance and  behavior  seems  to  be  genuinely  defective.  Of 


2/6  RACE  DECADENCE 

course  we  are  face  to  face  with  the  old  argument  that  those 
individuals  who  give  way  inordinately  to  self-weakening 
habits  must  in  the  first  place  have  been  mentally  defective. 
Says  one  experienced  observer :  "  In  those  instances  where 
one  has  observed  the  extremely  dragged-out,  typical  appear- 
ance popularly  attributed  to  this  trouble,  bad  sex  habits  have 
almost  never  been  discovered  to  stand  alone  as  a  cause." 

MENTAL  SUBNORMALITY  AND  BACKWARDNESS 

In  the  study  of  individuals  who  are  not  obviously  feeble- 
minded, one  cannot  escape  the  conclusion  that  there  is  a 
clearly  distinguishable  group  of  defectives  which  stands  be- 
tween feeble-mindedness  as  already  defined,  and  normality. 
For  lack  of  a  better  word  the  members  of  this  group  are 
usually  designated  as  subnormal  —  sometimes  backward. 

Healy  includes  the  following  classes  in  the  subnormal 
group : 

1 .  Those  who  in  spite  of  passing  the  Binet  tests,  still  may 
be  shown  to  have  such  lack  of  mental  ability  as  may  prevent 
their  normal  success. 

2.  Those  who  are  unable  to  pass  the  Binet  tests,  but  who 
are  socially  able  to  take  care  of  themselves  because  of  certain 
other  abilities  not  determinable  by  these  tests. 

3.  Those  who  during  school  age  at  least,  do  not  develop 
normally,  but  still  do  not  show  the  three  or  four  years  of  re- 
tardation which  in  that  period  is  the  authoritative  qualifica- 
tion for  being  considered  feeble-minded. 

4.  Then  there  is  need  for  a  class  in  which  to  put  cases 
when  we  are  temporarily  not  sure  of  anything  except  the 
fact  that  they  are  not  up  to  normal  in  mental  powers  as 
shown  by  tests.    There  is  often  considerable  cause  for  doubt 
in  the  case  of  a  backward  young  person  as  to  whether  the 
ultimate  diagnosis  will  be  feeble-mindedness  or  not.    Sensory 
disabilities  or  general  physical  conditions  may  perhaps  be 


THE  BACKWARD  CHILD  277 

partly  responsible  for  the  poor  showing  —  for  the  apparent 
backwardness. 

5.  Defect  in  self-control.  It  has  been  very  difficult  to  3e- 
cide  whether  this  characteristic  properly  belongs  under  the 
head  of  mental  defect.  After  long  consideration  of  this  prob- 
lem and  observation  of  the  outcome  in  a  number  of  cases  it 
seems  clear  that  a  certain  number  of  individuals  have  a 
special,  definite,  innate  defect  in  the  powers  of  self-control ; 
even  as  others  seem  to  show  defective  judgment  and  reason- 
ing powers. 

MARRIAGE  AND  THE  BACKWARD  CHILD 

The  laws  against  the  marriage  of  the  feeble-minded  are 
essentially  unscientific  because  they  seldom  attempt  to  define 
feeble-mindedness.  If  feeble-mindedness  were  always  as 
clearly  distinct  from  normality  as  are  certain  physical  de- 
formities, such  as  clubfoot,  then  there  could  be  no  objection 
to  the  law  on  this  score.  If  we  measure  the  mentality  of 
10,000  individuals  by  a  quantitative  test,  such  as  that  of  Binet 
and  Simon,  then  we  shall  find  that  the  retardation  in  mental 
development  for  one  year,  two  years,  three  years,  etc.,  shows 
nowhere  a  sharp  change  indicating  where  the  normal  ceases 
and  the  abnormal  begins.  Shall  we  sterilize  or  forbid  mar- 
riage to  all  children  whose  mental  development  is  retarded  as 
much  as  one  year  ?  That  would  probably  include  38  .per  cent 
of  all  children.  Shall  the  limit  be  two  years  of  retardation? 
That  would  include  18  per  cent  of  the  children.  Shall  the 
limit  be  three  years  ?  That  will  still  cover  over  8  per  cent — 
fully  one-twelfth  of  the  population  would  be  sterile. 

One  investigator  asks :  "  Have  we  even  good  ground  for 
denying  marriage,  generally  speaking  and  under  all  circum- 
stances, to  persons  who  as  school  children  were  even  four 
years  behind  their  fellows?  Is  it  certain  that  the  progeny  of 
such  a  person  will  be  four  years  older  than  their  classmates  at 


278  RACE  DECADENCE 

school,  or  three  years,  or  two  years,  or  even  one  year?  Is  it 
desirable  to  encourage  non-legal  and  irregular  unions  to  sus- 
tain a  law  passed  without  inquiry  and  based  on  no  certain 
knowledge  ?  " 

It  must  be  clear  to  all  that  a  child  may  be  evidently  back- 
ward without  necessarily  being  feeble-minded.  When  in 
doubt  regarding  such  a  case,  the  child  should  unquestionably 
be  given  the  benefit  of  the  doubt. 

In  the  case  of  laws  relating  either  to  segregation,  or  mar-- 
riage  —  they  should  be  .very  liberally  interpreted  when  the 
suspected  individual  is  regarded  as  being  merely  backward  — 
when  there  exists  any  serious  doubt  of  feeble-mindedness. 

A  careful  survey  of  the  whole  country  certainly  indicates 
that  backwardness  among  children  is  on  the  increase.  Part 
of  this  apparent  increase  is  due  merely  to  "  discovery  "  of 
the  situation;  but  even  when  every  allowance  is  made  for 
interpretative  errors  of  this  sort  —  it  can  hardly  be  doubted 
that  backwardness,  in  common  with  feeble-mindedness  of  the 
more  manifest  sort,  is  slowly  increasing  among  the  civilized 
races,  not  excepting  the  American  people.  Elsewhere,  the 
author  has  called  attention  to  the  possibility  of  some  phases 
of  this  backwardness  being  due  to  disturbances  in  the  endo- 
crine system  —  to  abnormalities  in  the  hormones  of  the  duct- 
less gland  system. 

SUMMARY  OF  THE  CHAPTER 

1.  The  backward  child  is  one  who,  while  not  discoverably 
defective,  is  in  some  measure  so  handicapped  that  it  is  not 
strictly  up  to  average  par. 

2.  Hickson  thinks  that  2  per  cent  of  Chicago  school  chil- 
dren are  backward  or  mentally  deficient. 

3.  Dr.  Gould  believes  there  is  a  direct  relation  between  eye 
troubles  and  backwardness  in  school  children. 

4.  The  United  States  Bureau  of  Education  says  5,000,000 


THE  BACKWARD  CHILD  279 

school  children  (25  per  cent)  have  defective  vision;  and  that 
15,000,000  (75  per  cent)  are  physically  defective. 

5.  Dr.  Richards  demonstrated  that  properly  fitted  glasses 
contributed  to  the  early  improvement  of  the  pupil's  work. 

6.  It  is  contended  that  even  minor  errors  of  vision  may 
be  indirectly  responsible  for  much  backwardness  and  other 
seemingly  abnormal  mental  attitudes. 

7.  A  recent  survey  of  86,000  Chicago  school  children  dis- 
closed a  formidable  list  of  physical  deficiencies  ranging  from 
defective  vision  down  to  adenoids  and  diseased  tonsils. 

8.  Wood  says  that  out  of  21,000,000  school  children  in  the 
United  States,  16,000,000  are  suffering  from  defects  which 
are  detrimental  to  health. 

9.  The  backward  child  embraces  a  large  group  —  a  class 
which  cannot  be  diagnosed  as  belonging  to  any  class  of  the 
feeble-minded  but  who  are,  nevertheless,  below  the  normal 
for  some  reason  indefinable. 

10.  There  are  also  those  whose  main  defect  is  lack  of  self- 
control  ;  while  others  seem  to  be  defective  only  as  regards  the 
exercise  of  reason  and  judgment. 

11.  One-third  of.  our  school  children  show  a  retardation 
of  one  year?  18  per  cent  two  years;  and  8  per  cent  three 
years. 

12.  Backwardness  seems  to  be  on  the  increase.     Part  of 
this  is  just  "  discovery,"  but  some  of  it  is  actual  and  is 
also  probably  hereditary. 

13.  In  case  of  laws  regulating  marriage  and  designed  to 
control    feeble-mindedness,    a    very    liberal    interpretation 
should  be  made  in  dealing  with  simple  backwardness. 

14.  It  is  possible  that  some  cases  of  apparent  hereditary 
backwardness  may  be  due  to  disturbances  in  the  endocrine 
system  —  the  ductless  glands. 


CHAPTER  XX 

FEEBLE-MINDEDNESS  IN  RELATION  TO 
CRIME 

WHAT  is  the  relation  between  vice,  crime,  drunken- 
ness, poverty,  and  mental  def ectiveness  ?  Are  these 
social  vices  and  individual  crimes  the  result  of  feeble-mind- 
edness  of  some  degree  on  the  part  of  the  perpetrators? 
What  is  it  that  heredity  is  responsible  for  —  feeble-minded- 
ness  or  crime?  Are  criminality,  immorality,  and  improvi- 
dence inherited  as  such ;  or  are  these  various  manifestations 
merely  the  result  of  the  inheritance  of  a  defective  mind  — 
f  eeble-mindedness  ? 

In  at  least  a  majority  of  these  cases  of  "  unsocial "  and 
"  antisocial "  conduct,  we  believe  the  fundamental  or  basic 
weakness  to  consist  of  the  inheritance  of  a  defective  mind; 
and  that  the  vice,  crime,  drunkenness,  shiftlessness,  and 
other  social  misbehavior  is  directly  or  indirectly  the  result 
of  this  inherent  feeble-mindedness.  We  believe  the  facts 
and  statistics  presented  in  this  chapter  go  a  long  way 
toward  establishing  this  contention,  when  considered  in  con- 
nection with  the  unbiased  study  of  the  whole  problem. 

It  is  not  our  intention  to  maintain  that  all  crime  grows 
out  of  mental  def  ectiveness  —  only  that  a  large  proportion 
of  it  does ;  and  we  freely  recognize  numerous  other  influences 
tending  toward  criminality. 

Not  only  do  we  sometimes  ascribe  crime  to  a  wrong  cause, 
but  we  not  infrequently  assign  feeble-mindedness  and  other 
defectiveness  to  wrong  causes.  Subnormality  is  ascribed 
to  malnutrition  of  the  fetus,  to  asphyxiation  of  the  child 

280 


FEEBLE-MINDEDNESS  AND  CRIME  281 

during  labor  at  birth,  to  adenoids,  to  infection  with  venereal 
disease,  head  injuries,  and  many  other  direct  and  individual 
causes  too  numerous  to,  mention,  despite  the  fact  that 
(excepting  Mongolian  idiocy)  it  usually  appears  only  in 
families  with  the  defect  on  both  sides  of  the  house. 

INFLUENCES    LEADING   TO    CRIME 

The  love  of  adventure  is  a  common  cause  of  minor  crimes 
among  young  offenders;  and  in  some  cases  even  among 
adults.  The  typical  cases,  however,  of  those  who  show  this 
mental  peculiarity  in  full  measure,  are  the  adolescents.  By 
"  love  of  adventure  "  is  meant  the  desire  for  self-expression 
and  for  self-activity  under  unusually  stimulating  conditions. 

One  of  the  commonest  of  human  traits  is  obstinacy. 
"The  obstinate  person  is  supposed  to  represent  the  very- 
antithesis  of  social  suggestibility,  and  yet  in  some  the  ten- 
dency to  opposition  and  perversity  is  as  clearly  set  along 
definite  lines  by  way  of  reaction  as  when  the  positive  forms 
of  suggestibility  are  shown.  It  is  the  old  story  of  the  in- 
dividual who  is  so  against  everything,  that  he  is  ready  to  do 
the  opposite  of  whatever  he  is  told."  Such  perverse  in- 
dividuals are  thus  disposed  to  commit  social  offenses.  One 
must  agree  with  McDougall  in  his  highly  original  essay  on 
the  subject,  that  in  certain  individuals  this  "  negative  reac- 
tion to  suggestion  appears  as  a  permanent  and  temperamen- 
tal attitude." 

A  stubbornly  persistent  form  of  self-assertion  is  the 
desire  for  revenge.  Within  limits  it  is  one  of  the  most 
naturally  expressed  emotional  reactions,  but  it  may  follow 
upon  anger  as  an  obsessional  phenomenon,  and  be  as  much 
a  sign  of  the  lack  of  self-control  as  anger  itself  is.  Says 
Healy :  "  The  desire  for  revenge  plays  a  considerable  part 
in  the  production  of  criminalistic  deeds  of  violence." 

Restlessness  can  be  a  great  factor  making  for  delinquency. 


282  RACE  DECADENCE 

It  is  sometimes  observed  in  cases  where  there  is  decidedly 
good  physical  strength  and  good  mental  powers.  In  most 
cases  it  is  found  that  this  sort  of  uneasiness  rests  on  some 
sort  of  physical  basis,  perhaps  inherited. 

The  greatest  interest  for  all  students  of  criminology  cen- 
ters about  the  fact  that  most  frequently  the  career  of  the 
confirmed  criminal  begins  during  adolescence.  Healy  says: 

As  we  look  over  our  adolescent  cases,  those  in  which  the  newly 
developed  mental  characteristics  of  the  period  play  a  considerable 
part,  we  find  always  the  admixture  of  causes  which  is  elsewhere 
seen.  But  we  can  fairly  enumerate  the  main  features  of  mental  life 
which  make  for  delinquency  at  this  epoch :  (a)  general  changeable- 
ness  or  instability  of  ideas  and  emotions,  and  consequently  of  char- 
acter; (b)  excessive  impulsions,  belonging  both  to  the  physical  and 
mental  spheres;  (c)  excessive  lack  of  self-control;  (d)  mental  and 
physical  lethargy  or  laziness;  (e)  the  general  feeling,  perhaps  only 
occasional,  of  recklessness;  (f)  hyper-sensitiveness,  as  shown  in 
romanticism,  dissatisfactions,  hypochondria,  etc.;  (g)  lack  of  fore- 
sight, which  is  perhaps  nothing  more  than  a  feature  of  childish 
mentality  carried  over  to  the  time  when  signs  of  adult  development 
are  showing  themselves;  (h)  egocentrism;  ambitiousness ;  these  with 
impulsiveness  and  lack  of  experience  may  lead  to  unfortunate  be- 
havior. Running  away  to  go  on  the  stage  is  an  example. 

Every  feeble-minded  person  is  a  potential  criminal.  They 
have  no  check  to  their  desires.  Whatever  they  desire  to  do, 
they  do.  Given  proper  circumstances  they  become  criminals. 
They  are  ungrateful,  ungenerous,  unsympathetic,  and  have 
no  consideration.  They  learn  only  vaguely.  The  higher 
types  make  friends  readily,  but  they  never  keep  them.  A 
moron  has  no  sense  of  moral  responsibility.  He  is  more 
dangerous  than  an  adolescent  neuropath  or  a  hysteric. 

ENVIRONMENTAL    FACTORS   IN    CRIME 

It  is  not  always  easy  to  decide  between  opposing  argu- 
ments on  causation  of  crime,  for  instance  those  of  the 
heredity  specialists  versus  the  environmental  enthusiasts. 


FEEBLE-MINDEDNESS  AND  CRIME  283 

One  student  of  crime  and  criminals  offers  the  following 
suggestions  regarding  influences  predisposing  to  crime: 

/.  Parent  alcoholic. —  The  influence  of  an  alcoholic  parent 
on  home  conditions  that  produce  delinquency  is  one  of  the 
plainest  facts  observed  in  the  study  of  criminalistics. 

2.  Immoral  home  environment. —  Whether  or  not  the 
parents  show  active  criminalism  or  immorality,  the  moral 
conditions  surrounding  the  home  may  naturally  be  a  vital 
point  in  the  production  of  delinquency. 

5.  Irritation  at  home. —  One  hears  extensively  of  the 
effect  of  quarreling  and  nagging  and  teasing  as  causes  of 
delinquency,  both  from  offenders  and  their  relatives. 

4.  Severity  and  harshness  of  parent. —  The  effect  of  sever- 
ity on  the  part  of  a  parent  may  have  a  direct  reaction  in 
delinquency.    As  we  have  to  reckon  with  such  behavior,  it 
runs  all  the  way  from  mere  repression  to  putting  the  child 
our-of-doors,  or  actual  fighting. 

5.  Home  uncongeniality. —  One  of  the  most  peculiar  phases 
of  family  life  that  has  come  to  our  notice  as  a  cause  of 
delinquency  is  the  uncongeniality  that  arises  through  a  young 
individual  desiring  to  better  himself. 

6.  Parents  separated. —  A  very  fruitful  source  of  delin- 
quency is  found  in  the  separation  of  parents,  either  with  or 
without  divorce. 

7.  Crowded   housing   conditions. —  The  material   founda- 
tions of  social  life  deeply  influence  morality.    In  the  matter 
of  the  many  decencies  that  depend  upon  housing  conditions 
this  stands  out  very  clearly.    A  considerable  cause  of  sexual 
vice  is  to  be  found  in  the  spacial  circumstances  of  home  life. 

8.  Poverty. —  It  is  not  necessary  to  expatiate  on  the  general 
relation  of  poverty  to  criminalism. 

p.  No  home. —  An  adolescent  without  a  home  is  under  the 
most  favorable  circumstances  for  the  establishment  of  crimi- 
nalistic  behavior. 


284  RACE  DECADENCE 

10.  Parental  neglect. —  The  subject  of  the  effect  of  paren- 
tal neglect  as  productive  of  delinquency  is  altogether  too  trite 
to  be  dwelt  on  in  detail. 

11.  Bad  companions. —  As  observed  in  any  phase  of  court 
life,  bad  companions  play  an  immense  part  in  the  production 
of  criminalism  —  though  some  seem  to  prefer  solitary  crime. 

12.  Theaters. —  Possible  effects  of  theatrical  presentations 
in  producing  criminalism  is  obvious.    High-priced  plays  are, 
as  a  rule,  not  seen  by  adolescents,  and  it  is  doubtful  if  theaters 
ever  influence  toward  criminalistic  conduct  except  at  this 
impressionable  age.     Melodramas  urge  to  action  much  as 
moving  pictures  do,  and  there  cannot  be  the  slightest  doubt 
that  the  stimulation  of  certain  shows  is  towards  misconduct  in 
sex  affairs. 

JJ.  Social  allurements. —  The  various  allurements  of  social 
life  which  stand  out  in  the  causation  of  delinquency  form  a 
great  variety  which  are  too  long  to  recount.  We  find,  for 
instance,  a  defective  boy,  who  is  a  great  runaway,  always 
going  to  the  shops  down  town.  The  allurements  of  fine 
clothes  as  worn  by  others,  or  as  seen  in  shop  windows,  is,  to 
those  who  have  a  native  desire  for  finery,  an  undoubted 
temptation  which  may  result  in  some  form  of  dishonest 
acquirement. 

14.  School  irritation. —  As  part  of  the  psychical  environ- 
ment we  must  very  properly  reckon  with  this  factor,  although 
in  the  study  of  the  individual  the  prime  cause  would  undoubt- 
edly be  the  personal  peculiarity  which  leads  to  the  irritation. 

15.  Unsatisfactory  vocation. —  On  some  occasions  we  have 
found  hypersensitive  adolescents  to  whom  the  vocations  they 
were  following  were  highly  irritative,  and  who  showed  delin- 
quent tendencies  as  a  result. 

16.  Influence  of  newspapers. —  Consideration  of  the  ques- 
tion of  the  influences  of  newspapers  in  producing  antisocial 
conduct  has  brought  forth  surprising  results.    It  would  seem, 


FEEBLE-MINDEDNESS  AND  CRIME  285 

a  priori,  that  the  great  amount  of  material  which  the  news- 
papers publish  relating  to  delinquency  must  certainly  very 
definitely  harm  the  readers ;  the  only  reason  they  do  no  more 
harm  is  the  fact  that  most  criminal  careers  are  begun  before 
the  newspaper  reading  age. 

17.  Jails  and  prisons. —  Lombroso  says :  "  One  of  the 
greatest  factors  in  crime  is  the  prison."  Tarde  says :  "  The 
criminal  is  partly  the  result  of  his  own  crime  and  partly  of 
criminal  justice."  And  Holmes  says :  "  Why  is  it  that  a 
man's  facial  expression  changes  during  a  long  detention? 
Why  is  it  that  his  voice  becomes  hard  and  unnatural  ?  Why 
is  it  that  his  eyes  become  shifty,  cunning,  and  wild?  It  is 
not  because  of  hard  work;  it  is  the  system  that  does  it,  the 
long-continued  soul-and-mind-destroying  monotony." 

RACE  AND   CRIME 

The  racial  composition  of  the  population  doubtless  has 
considerable  influence  on  the  amount  of  lawbreaking. 
Figures  show  that  there  are  proportionately  more  commit- 
ments among  the  Negro  population  than  among  the 
white,  and  more  among  the  foreign-born  white  population 
than  among  the  native  white.  Moreover,  there  appears  to 
be  considerable  difference  in  this  respect  between  the  differ- 
ent classes  of  immigrants  as  distinguished  by  country  of  birth. 
Sex  and  age  are  other  factors  of  some  importance  in  this 
connection.  The  great  majority  of  the  offenders  committed 
to  prisons  and  jails  are  adult  males ;  only  about  2  per  cent  of 
the  total  number  of  prisoners  and  juvenile  delinquents  com- 
mitted are  under  15  years  of  age  and  only  about  10  per  cent 
are  females.  It  follows,  therefore,  that  a  community  or  class 
in  which  there  is  a  relatively  large  percentage  of  adult  males 
is  likely  to  have  a  higher  ratio  of  prison  commitments  than 
one  in  which  there  is  a  relatively  large  proportion  of  females 
and  children.  In  fact  it  will  be  found  from  statistics  that 


286  RACE  DECADENCE 

the  difference  jtist  noted  between  the  native  white  and  for- 
eign-born white,  as  regards  the  ratio  of  commitments,  is 
largely  accounted  for  by  the  difference  in  the  age  composi- 
tion of  the  two  classes. 

That  illiteracy  is  a  factor  which  may  have  some  connec- 
tion with  the  frequency  of  prison  commitments  is  indicated 
by  statistics.  These  statistics  show,  at  any  rate,  that  the 
percentage  of  illiteracy  is  higher  among  prisoners  than  in  the 
general  population  in  the  same  community;  but,  on  the  other 
hand,  it  is  a  question  whether  in  some  communities  where 
there  is  a  high  degree  of  illiteracy  there  may  not  be,  as 
compared  with  other  communities,  a  more  lax  enforcement 
of  the  laws  and  fewer  legal  restrictions  or  prohibitions,  par- 
ticularly as  regards  such  offenses  as  drunkenness,  disorderly 
conduct,  vagrancy,  and  prostitution.  In  short,  there  may  be 
in  such  communities  less  law  and  likewise  more  lawlessness 
than  in  other  communities  where  the  population  is  less 
illiterate. 

WHO  IS  FEEBLE-MINDED? 

It  is  desirable  that  the  suspected  subnormal  individual 
should  be  correctly  diagnosed,  so  that,  for  example,  backward 
children  may  not  be  forced  to  spend  all  their  school  days  with 
feeble-minded  children  in  special  schools,  and  so  that  back- 
ward prostitutes  and  backward  juvenile  and  adult  delinquents 
shall  not  be  diagnosed  as  feeble-minded,  in  order  to  incar- 
cerate them  in  some  custodial  institution  for  life,  or  to 
exculpate  them  from  accountability  for  the  commission  of 
some  crime.  Binet  says  heedlessness  and  lack  of  attention 
may  cause  falling  into  the  trap.  This,  as  we  see  it,  is  exactly 
how  in  social  life  certain  individuals  from  empty-headedness 
or  lapses  of  will  receive  criminalistic  suggestions.  The  in- 
dividual, through  certain  negative  aspects  of  his  mental  life, 
is  more  passive  and  suggestible  than  he  might  be  otherwise. 


FEEBLE-MINDEDNESS  AND  CRIME  287 

The  Binet-Simon  rule  of  determining  feeble-mindedness  is 
to  subtract  the  individual's  age  as  shown  by  the  tests  from 
his  actual  age,  and  to  class  the  individual  as  feeble-minded  if 
he  shows  an  "  intellectual  retardation  of  two  years  at  an  age 
below  nine,  or  three  years  at  and  above  nine." 

The  greatest  difficulty  with  this  whole  thing  is  the  fact  that 
so  many  of  these  tests  are,  or  have  been,  made  by  amateurs  — 
by  persons  not  properly  trained  or  experienced  for  such  work. 
Expert  re-examination  does  not  always  qonfirm  their  diagno- 
sis; and  so  it  is  demonstrated  that  the  average  amateur  can 
only  accurately  diagnose  the  most  obvious  cases  of  feeble- 
mindedness, let  alone  be  able  to  make  a  differential  diagnosis 
as  between  the  various  types  and  degrees  of  mental  subnor- 
mality  and  defectiveness.  The  making  of  this  sort  of  a  diag- 
nosis should  be  regarded  as  a  serious  responsibility. 

Evidently  the  tacit  assumption  has  been  that  the  basis  of 
classification  which  has  been  used  is  universally  accepted  and 
therefore  need  not  even  be  stated,  much  less  explained  or  jus- 
tified, although  the  literature  clearly  shows  that  the  whole 
matter  of  the  criteria  or  standards  of  feeble-mindedness  is 
still  in  controversy.  Many  examiners  do  not  give  even  a 
hint  as  to  the  adequacy  of  their  examinations  —  the  thor- 
oughness of  the  Binet  testing,  or  the  extent  of  the  psycho- 
logical, medical,  developmental,  and  social  examination. 
Many  of  the  writers  do  not  tell  us  whether  the  1908  or  1911 
scale  was  used,  whether  the  1913  suggestions  were  followed, 
whether  the  tests  above  age  12  were  given,  and  whether  the 
Binet  rating  included  the  latter  tests. 

The  author  confidently  believes  that  feeble-mindedness  is 
on  the  increase  —  that  it  constitutes  a  national  menace  —  but 
he  also  feels  that  in  some  quarters  there  exists  a  tendency 
unduly  to  magnify  the  evil  and  otherwise  to  exaggerate  the 
dangers.  What  is  desired  is  the  truth  —  facts  —  and  these 
are  serious  enough  to  stir  us  to  action.  A  sane  people  do  not 


288 


RACE  DECADENCE 


require  to  be  scared  into  hasty  and  immature  action  by  over- 
magnification  of  the  dangers  which  threaten  us. 

A  SURVEY  OF  CRIME 

That  the  reader  may  gain  an  idea  of  the  importance  of 
mental  defectiveness  as  a  cause  of  crime,  in  relation  to  all 
other  influences,  the  following  summary  of  a  study  of  823 
cases  (560  males  and  263,  females)  made  by  the  Chicago 
Psychopathic  Laboratory,  is  here  given : 


Groups  of 
causative  factors 

Number   of 
times  a  p  - 
peared  to  be 
main  factor 

Number  of 
times  ap- 
peared to  be 
minor  factor 

Total   number 
of  times  ap- 
peared as  fac- 
tor 

Mental  abnormalities  and 

455 

135 

590 

Defective  home  conditions  including 
alcoholism  

162 

394 

556 

58 

15 

73 

Improper  sex  experiences  and  habits 

46 
44 

146 

235 

192 
279 

Abnormal  physical  conditions,  includ- 
ing excessive  development  

40 

233 

273 

Defects  of  heredity  

502 

502 

Defective  or  unsatisfied  interests,  in- 
cluding misuse  or  nonuse  of  special 
abilities  

16 

93 

109 

Defective  early  developmental  con- 
ditions   

214 

214 

Mental  shock  

3 

3 

Deliberate  choice  

1 

1 

1 

1 

Use  of  stimulants  or  narcotics  

92 

92 

Experiences  under  legal  detention.  .  . 
Educational  defects  extreme  

15 
20 

15 

20 

823 

2,097 

2,920 

The  conclusions  of  these  psychologic  and  expert  investiga- 
tors are: 

It  was  clearly  evident  that  classification  by  crimes  leads  only  in 
special  instances  to  knowledge  of  the  criminal;  that  statistics  of 
seasons,  and  races,  and  head  measurements,  and  alcoholism,  and 
so  on,  mean  almost  nothing  for  the  fundamental  understanding  of 
the  individual  case ;  that  epileptic  and  atavistic  theories  could  not  be 
substantiated  by  case  histories ;  that  refinements  of  psycho-physical 
measurements  sometimes  used  on  criminals  need  a  tremendous 
amount  of  overhauling  before  they  can  be  regarded  as  valid  for 


FEEBLE-MINDEDNESS  AND  CRIME  289 

conclusions;  that  the  elders,  who  spoke  so  glibly  of  "the  criminal" 
as  a  born  type,  had  not  the  means  of  investigating  whether  he  was 
not  rather  a  born  defective,  and  a  criminal  through  accident  of 
environment. 

This  last  consideration  alone  is  enough  to  make  the  student  look 
askance  at  all  the  older  classifications.  The  statistics  that  are  offered 
concerning  criminals,  whether  about  their  heads,  their  ears,  their 
religious  faith,  or  what  not,  are  presented  without  knowledge  of 
essential  facts,  such  as  whether  or  not  they  were  mentally  defective; 
and  thus  lead  us  nowhere  for  purposes  of  practical  treatment.  We 
see  segregated  in  institutions  the  feeble-minded  with  just  these  stig- 
matized skulls  and  palates  and  ears.  We  find  well-developed  stig- 
mata sometimes  in  those  who  are  morally  normal.  So  it  seems  that 
by  virtue  of  education  or  social  protection,  such  marked  individuals 
need  not  become  criminals. 

CRIMINALS  AS  A  CLASS 

Criminality  is  an  old  battle-ground  where  many  conflicts 
have  been  fought  between  the  champions  of  the  theories  of 
heredity  versus  environment  as  the  chief  cause  of  crime.  Are 
criminals  born  or  are  they  made  by  their  surroundings? 
Laws  such  as  have  been  passed  in  several  states  providing  for 
the  sterilization  of  criminals  as  such,{  must  be  deplored  by 
the  eugenist  as  much  as  they  are  by  the  pseudo-sociologist 
who  "  does  not  believe  in  heredity ;"  but  this  is  not  saying 
that  there  are  not  many  cases  in  which  eugenic  action  is 
desirable;  for  inheritance  of  a  lack  of  emotional  control 
makes  a  man  in  one  sense  "  a  born  criminal."  x  He  is  not, 
in  most  respects,  the  creature  he  was  made  out  to  be  by 
Lombroso  and  his  followers ;  but  he  exists,  nevertheless,  and 
no  ameliorative  treatment  given  him  will  be  of  such  value  to 
society  as  preventing  his  reproduction. 

In  any  investigation  of  criminals,  the  benefit  of  doubt 
should  be  given  to  the  individual.  But  when  every  possible 
concession  is  made  to  the  influence  of  environment,  the 


1  See  recent  studies  of  C.  B.  Davenport,  particularly  The  Feebly 
Inhibited,  Carnegie  Institution,  Washington,  1915. 


290  RACE  DECADENCE 

psychiatric  study  of  the  individual,  and  the  investigation  of 
his  family  history  still  show  that  there  are  criminals  who  con- 
genitally  lack  the  inhibitions  and  instincts  which  make  it  pos- 
sible for  others  to  be  useful  members  of  society.  When  a 
criminal  of  this  natural  type  is  found,  the  duty  of  society  is 
unquestionably  to  protect  itself  by  cutting  off  that  line  of 
descent. 

As  a  result  of  a  recent  psychic  study  of  the  inmates  of  Sing 
Sing  it  was  said  that  two-thirds  of  them  showed  some  mental 
defect.  Examination  of  100  convicts  selected  at  random  in 
the  Massachusetts  State  Prison  showed  that  29  per  cent  were 
feeble-minded  and  1 1  per  cent  borderline  cases.  The  highest 
percentage  of  mental  defectives  was  found  among  criminals 
serving  sentence  for  murder  in  the  second  degree,  manslaugh- 
ter, burglary,  and  robbery.1  Paul  M.  Bowers  told  the  1916 
meeting  of  the  American  Prison  Association  of  his  study  of 
100  recidivists,  each  of  whom  had  been  convicted  not  fewer 
than  four  times.  Of  these  12  were  insane,  23  feeble-minded, 
and  10  epileptic,  and  in  each  case  Dr.  Bowers  said  the  mental 
defect  bore  a  direct  causal  relation  to  the  crime  committed. 
It  is  just  as  sensible  to  imprison  a  person  for  feeble-minded- 
ness  or  insanity  as  it  is  to  imprison  criminals  belonging  to 
these  defective  strains.  The  question  whether  a  given  person 
is  a  case  for  the  penitentiary  or  the  hospital  is  not  primarily 
a  legal  question,  but  one  for  a  physician  with  the  aid  of  a 
student  of  heredity  and  family  histories. 

CRIMINAL  HEREDITY 

Most  students  of  crime,  as  well  as  observers  of  heredity, 
have  reached  the  conclusion  that  criminality  —  as  such  —  is 
not  hereditary ;  that  the  thing  which  is  undoubtedly  inherited 
and  which  is  associated  with  crime,  is  some  form  of  mental 


1  Rossy,  C.  S.,  in  State  Board  of  Insanity  Bulletin,  Boston,  Novem- 
ber, 1915. 


FEEBLE-MINDEDNESS  AND  CRIME  291 

defect.  In  other  words,  we  agree  with  Aschaffenburg,  who 
said :  "  This  makes  it  possible  to  dispense  with  the  hypothesis 
that  criminal  tendencies,  like  artistic  talents  for  instance,  are 
transmitted  from  parents  to  children.  I  expressly  say  that 
we  can  dispense  with  it,  for  it  cannot  be  refuted  or  proved." 
Such  an  experienced  investigator  as  Healy  says : 

From  our  experience  we  would  warn  at  this  place,  once  more, 
against  the  danger  of  drawing  easy  conclusions  about  heredity  being 
the  main  factor  back  of  misdeeds  simply  because  some  progenitors 
or  other  members  of  the  family  were  guilty  of  delinquency.  Both 
mother  and  child  may  be  prostitutes,  and  both  be  victims  of  environ- 
ment. Grandparents  and  parents  and  children  may  be  liars,  or 
thieves,  or  misdoers  in  other  ways,  and  very  little  cause  of  their 
conduct  be  protoplasmic  carrying  over  of  special  traits.  Some 
changes  or  reformations  that  may  be  witnessed  through  alteration 
of  environment,  make  one  very  skeptical  about  deciding  the  role 
of  inheritance  in  criminalism,  unless  other  proof  than  that  of  similar 
misconduct  in  successive  generations  is  brought  forth.  We  feel 
certain  that  absolutely  the  only  fair  way  to  study  inheritance  in 
cri&inalistic  families  is  to  ascertain  the  various  causes  of  mis- 
behavior in  individual  cases,  and  then  to  reckon  up  these  with  known 
heritable  conditions. 

Among  those  traits  of  character  or  tendencies  of  tempera- 
ment (not  to  be  classed  as  evidence  of  mental  defectiveness) 
which  seem  to  predispose  certain  otherwise  unstable  individ- 
uals to  crime,  may  be  mentioned:  inheritance  of  excess  of 
energy;  irritability  of  temper;  hyper-sexual  tendencies;  other 
abnormal  physical  traits;  alcoholism  during  pregnancy;  and 
congenital  syphilis. 

At  the  first  Eugenics  Congress  in  London,  one  of  the 
speakers  expressed  a  preference  for  the  son  of  a  husky 
burglar  over  the  son  of  a  tuberculous  bishop.  This  is  doubt- 
less quite  correct,  but  why  should  the  bishop  be  tuberculous  ? 
The  truth  of  the  matter  is,  the  reverse  is  more  likely  to  be 
the  case.  In  dealing  with  criminals,  then,  with  a  view  to 
cutting  off  their  posterity,  we  must  be  careful  to  understand 
whether  we  are  dealing  with  a  hereditary  feeble-mindedness 


292  RACE  DECADENCE 

or  an  acquired  criminality.  If  there  is  a  genuine  hereditary 
criminal  taint,  society  is  right  in  freeing  itself  of  it.  If  it  is 
acquired,  the  criminals,  if  placed  in  good  environment,  are 
likely  to  become  good  citizens. 

I  no  longer  believe  in  the  existence  of  a  hereditary  crimi- 
nal class.  I  do  not  believe  there  is  a  typical  criminal  class. 
Criminals  are  such  because  of  the  inheritance  of  definite  or 
general  mental  defects,  or  because  they  turn  to  crime  as  the 
path  of  least  resistance  as  regards  the  circumstances  of  their 
environment,  temperament,  health,  vices,  etc. 

FEEBLE-MINDEDNESS    AND   CRIME 

In  the  Psychopathic  Laboratory  of  the  Boston  Municipal 
Courts,  350  criminals  (210  women  and  140  men)  were  care- 
fully examined  in  regard  to  their  mentality,  with  the  follow- 
ing results: 

Mental  defectives   31.1  per  cent 

Constitutional  psychopaths  24.2  per  cent 

Subnormal   20.2  per  cent 

Dementia    praecox    3.5  per  cent 

Epileptics    3-5  per  cent 

Unclassified  neurotics    10.2  per  cent 

Normal   7-3  per  cent 

The  Psychopathic  Laboratory  of  the  Kansas  State  Prison 
gave  out  the  following  report  on  the  examination  of  224 
white  and  101  colored  convicts: 

White  Men 

Morons    68.8  per  cent 

Subnormal   16.5  per  cent 

Normal   14-7  per  cent 

Colored  Men 

Morons   90.2  per  cent 

Subnormal   5-9  per  cent 

Normal   3.9  per  cent 


FEEBLE-MINDEDNESS  AND  CRIME  29$ 

Wherever  investigations  of  a  scientific  character  have  been 
made  as  touching  feeble-mindedness  in  the  criminal  popula- 
tion, they  unfailingly  show  anywhere  from  65  to  85  per  cent 
of  criminals  to  be  mental  defectives  of  some  degree. 

The  author  believes  that  it  is  the  feeble-mindedness  that 
is  hereditary  —  not  the  criminality.  Criminals,  as  such,  are 
not  born ;  potential  criminals  are  —  because  they  inherit  these 
mental  defects  which  predispose  them  to  a  life  of  crime  or 
some  other  abnormal  or  unsocial  pursuit. 

PHYSICAL  SIDE  OF  CRIME 

Attention  has  already  been  called  to  the  prevalence  of  eye 
disorders  among  the  inmates  of  penal  institutions.  Dr.  Case, 
at  the  Elmira  Reformatory,  found  that  the  number  of  boys 
suffering  from  serious  defects  of  vision  was  56  per  cent,  and 
th^s  without  the  use  of  medicine  in  the  eyes.  Dr.  Orton, 
of  the  New  Jersey  Reformatory,  found  in  his  last  series  of 
125  cases  that  without  the  use  of  medicine  only  35  per  cent 
of  the  boys  apparently  needed  glasses.  When  he  used  the 
medicine,  83  per  cent  of  the  boys  needed  glasses.  In  a  former 
state  of  civilization,  or  even  now  in  the  country  districts,  a 
boy  who  was  afflicted  with  defective  vision  could  earn  a 
living.  To  quote  a  justice  of  the  Court  of  Special  Sessions 
of  New  York  City,  "  a  boy  in  the  country  can  see  a  cow  on 
the  other  side  of  a  fence  no  matter  how  bad  his  eyes  are," 
and  herding  pigs  has  never  been  cited  as  a  cause  of  eyestrain 
even  by  the  most  ardent  disciples  of  that  gospel.  In  the 
city,  however,  the  case  is  quite  different.  Most  of  the  work 
in  city  life  requires  the  near  use  of  eyes  for  long-continued 
periods.  Applicants  for  positions  in  some  of  our  large  cor- 
porations are  tested  for  eyesight,  and  if  it  is  not  good  they 
are  rejected.  Even  if  applicants  with  bad  eyes  are  accepted 
they  are  frequently  unable  to  perform  their  duties  satisfac- 
torily, and  are  soon  discharged.  As  an  example  of  this,  the 


294  RACE  DECADENCE 

New  York  Telephone  Company  refuses  thousands  of  appli- 
cants every  year  on  account  of  bad  vision,  though  the  ordinary 
person  would  never  think  of  eyes  in  connection  with  a 
telephone. 

In  the  DeWitt  Ointon  High  School,  in  New  York  City, 
is  a  class  of  thirty-seven  defectives  who  have  failed  in  every 
subject.  Nothing  else  could  be  done  with  them,  so  they  were 
put  in  charge  of  the  physical  culture  instructor,  who  reported 
to  the  principal  that  they  were  "  a  lot  of  crooks,  thieves, 
and  gamblers."  Now,  the  most  cursory  examination  of  these 
boys'  eyes  as  compared  with  those  of  a  normal  class  in  the 
next  room  showed  that  these  defective  boys  averaged  less 
than  half  as  good  eyesight.  Does  it  require  any  special  gift 
of  prophecy  to  foretell  that  in  the  course  of  the  next  ten  or 
fifteen  years  almost  all  of  these  boys  will  go  the  usual  route 
of  crime,  reformatory,  and  prison? 

The  medical  profession  is  awakening  to  the  fact  that  a 
large  number  of  diseases  are  due  to  conditions  in  the  nose 
as  an  underlying  cause,  and  mouth-breathing  as  its  conse- 
quence. From  this  come  long-continued  colds  in  the  head, 
attacks  of  sore  throat  or  tonsillitis,  catarrhal  deafness  (which 
constitutes  95  per  cent  of  all  deafness),  and  as  a  result  of 
mouth-breathing  either  by  day  or  night,  a  greater  deposit 
of  tartar  is  made  around  the  gum-line  of  the  teeth,  and  thus 
the  foundation  is  laid  for  the  retention  of  food  particles, 
which  frequently  goes  on  to  the  formation  of  pus  around  the 
teeth,  with  their  consequent  decay  and  loss.  Many  cases  of 
appendicitis  could  be  traced  to  this  source  of  infection,  and 
many  surgeons  now  refuse  to  operate  for  this  disease  until 
the  teeth  have  been  put  in  a  healthy  condition  —  except  in  the 
case  of  acute  appendicitis. 

Among  the  physical  conditions  or  defects  so  commonly 
found  in  criminals  should  be  noted:  speech  defects;  deaf- 
mutism;  enuresis;  local  irritations;  headaches;  head  in- 


FEEBLE-MINDEDNESS  AND  CRIME  295 

juries ;  as  well  as  the  use  of  alcohol,  drugs,  tobacco,  and  even 
excessive  use  of  tea  and  coffee. 

THE  BOYS'   COURT 

The  findings  herewith  presented  are  based  upon  the  labora- 
tory analysis  of  4,539  individual  cases,  which  have  passed 
through  the  Municipal  Court  of  Chicago  during  a  recent 
three-year  period.  Among  the  important  facts  set  forth  in 
the  report,  as  proved  by  laboratory  research  and  experience, 
may  be  listed  the  following : 

That  2  per  cent  of  the  population  is  criminally  inclined. 

That  2  per  cent  of  the  population  is  defective  mentally. 

That  a  large  percentage  of  mental  defectives  are  absolutely  in- 
curable criminals. 

That  the  mentally  defective  criminal  propagates  defectives  who 
will  be  criminals. 

That  present  criminal  reform  methods  and  punishment  are  largely 
futtie  as  protection  to  society. 

Tnat  little  decrease  in  crime  may  be  expected  until  present  ob- 
solete school  instruction  methods  are  changed ;  and  permanent 
segregation  of  the  criminally  defective  is  provided  for. 

Psychologic  laboratory  research  activities  have  demon- 
strated not  only  that  a  large  proportion  of  the  cases  in  all  of 
our  courts  indicate  that  the  defendants  are  mental  defectives, 
but  also  that  the  same  defendants  in  hundreds  of  instances 
appear  in  the  various  branch  courts.  It  has  been  established 
that  the  great  majority  of  the  defendants  have  previously  been 
in  the  Juvenile  Court,  and  even  before  that  had  trouble,  as 
children,  in  the  schools. 

Statistics  of  the  Boys'  Court  are  of  especial  interest  as 
indicating  that  this  group  of  defendants,  popularly  supposed 
to  be  first  offenders,  is,  for  the  most  part,  made  up  of  young 
but  confirmed  criminals  who  offer  few  possibilities  of  per- 
manent reform. 

The  role  of  feeble-mindedness  in  the  causation  of  crime  is 


296  RACE  DECADENCE 

fully  demonstrated  by  the  fact  that  85  per  cent  of  the  youths 
brought  into  the  Boys'  Court  of  Chicago  are  feeble-minded, 
subnormal,  or  mentally  defective  in  some  degree. 

JUVENILE  DELINQUENTS 

The  total  number  of  juvenile  offenders  under  18  years 
of  age  reported  by  the  last  special  census  study  as  committed 
to  penal  or  reformatory  institutions  was  25,422.  As  com- 
pared with  the  total  population  under  18  years  of  age,  this 
represents  a  ratio  of  72.9  per  100,000.  In  view  of  the  fact, 
however,  that  children  under  10  years  of  age  are  not  ordi- 
narily considered  as  capable  of  committing  a  violation  of  the 
law,  a  fairer  measure  of  juvenile  delinquency  would  be  a 
comparison  between  the  juvenile  offenders  10  to  17  years  of 
age  and  the  total  population  of  the  same  age.  Since  568  of 
the  juvenile  offenders  reported  were  under  10  years  of  age, 
the  number  from  10  to  17  years  of  age  committed  was  24,854, 
which  represents  a  ratio  of  171.7  per  100,000  of  the  general 
population  of  corresponding  age.  The  corresponding  ratio 
for  offenders  18  years  of  age  or  over  was  820.5  per  100,000 
population  of  the  same  age.  This  difference  in  the  ratios  for 
juvenile  and  adult  offenders  is  of  course  not  surprising,  since 
juveniles  lack  the  opportunity  or  the  temptation  to  commit 
many  of  the  crimes  for  which  adults  are  imprisoned,  and  it 
is  furthermore  the  tendency  to  a  considerable  degree  to  send 
juvenile  offenders  to  a  penal  or  reformatory  institution  only 
after  all  other  means  of  correction  have  failed. 

Expert  authorities  are  now  agreed  that  heredity  —  feeble- 
mindedness —  is  the  chief  factor  in  the  causation  of  all  delin- 
quencies. While  many  different  causes  enter  into  the  produc- 
tion of  juvenile  delinquency,  the  more  careful  investigators 
are  coming  to  the  conclusion  that  hereditary  inferiority  is  the 
basic  explanation.  Social  and  economic  reforms  all  have  their 
place  in  our  general  scheme  of  "  uplift,"  but  eugenics  is,  after 


FEEBLE-MINDEDNESS  AND  CRIME  297 

all,  the  true  solution  of  the  most  of  our  so-called  social  prob- 
lems of  this  sort. 


SUMMARY  OF  THE  CHAPTER 

1.  Criminality,   immorality,   improvidence,   and  drunken- 
ness are  not  inherited  as  such ;  they  are  merely  various  mani- 
festations of  inherent  feeble-mindedness. 

2.  In  the  majority  of  cases  of  "  antisocial  "  conduct,  the 
fundamental  weakness  is  the  inheritance  of  a  defective  mind. 

3.  Subnormality  is  often  ascribed  to  prenatal  influence,  ab- 
normal birth,  adenoids,  and  injuries;  whereas  the  defect  lies 
in  the  ancestral  germ-plasm. 

4.  Among  the  influences  leading  to  crime    (other  than 
feeble-mindedness)    may    be    named:    love    of    adventure, 
obstinacy,  revenge,  restlessness,  particularly  at  the  adolescent 
period. 

5.  Every    feeble-minded  person  is  a  potential  criminal. 
Th4y  are  ungrateful,  unsympathetic,  and  inconsiderate.  They 
lack  a  moral  sense  of  responsibility. 

6.  Of  the  non-hereditary  influences  predisposing  to  crime 
may  be  mentioned :  alcoholic  parents,  immoral  environment, 
uncongenial  home,  poverty,  divorced  parents,  evil  associates, 
crime  displayed  in  press  or  in  movies,  idleness,  and  the  bad 
influence  of  correctional  institutions. 

7.  Other  factors  in  determining  crime  are :  race,  age,  sex, 
and  illiteracy. 

8.  Backwardness,  heedlessness,  lack  of  proper  training,  and 
poor  discipline  may  lead  to  associations  which  foster  crime. 

9.  While  mental  defectiveness  is  undoubtedly  on  the  in- 
crease ;  nevertheless,  there  exists  in  some  quarters  a  tendency 
unduly  to  magnify  this  national  menace  —  even  though  it  be. 

10.  In  the  study  of  823  crimes,  mental  abnormality  was 
the  major  factor  in  455  and  the  minor  factor  in  135  cases. 

11.  The  older  theories  regarding  crime  as  a  disease  and 
what  not,  must  give  way  before  the  hard  facts  that  it  is,  in 
the  majority  of  cases,  the  outcome  of  a  bad  heredity. 

12.  Criminals  are  born  —  they  come  into  the  world  predis- 
posed to  crime  by  their  inherent  mental  defectiveness.    En- 


RACE  DECADENCE 

vironment  is  only  a  determining  factor  in  their  delinquency. 

13.  Instead  of  enacting  laws  to  sterilize  habitual  criminals 
we  should  have  laws  for  the  sterilization  of  feeble-minded 
criminals. 

14.  Two-thirds  of  the  inmates  of  Sing  Sing  prison  showed 
some  mental  defect.     In  Massachusetts  40  per  cent  of  con- 
victs were  defective. 

15.  In  the  case  of  100  criminals,  each  of  whom  had  been 
convicted  at  least  four  times,   12  were  insane,  23   feeble- 
minded, and  10  epileptic. 

1 6.  Criminal  tendencies  are  not  transmitted  from  parent 
to  child  like  artistic  talents;  the  thing  which  is  transmitted 
is  the  mental  defect  of  the  tainted  ancestral  germ-plasm. 

17.  But  not  all  crime  comes  from  hereditary  deficiencies; 
some  is  the  result  of  errors  on  the  part  of  society  and  on  the 
part  of  parents  who  failed  early  to  inculcate  the  respect  for 
law  and  authority  into  their  offspring. 

18.  Physical  defects  are  also  related  to  criminal  tenden- 
cies.    Bad  vision  and  other  bodily  disorders  contribute  to 
delinquency. 

19.  In  criminals  we  so  commonly  find  headaches,  bad  teeth, 
nose  and  throat  disorders,  enuresis,  deaf-mutism,  drug  habits, 
etc. 

20.  A  study  of  crime  in  the  Boys'  Court  of  Chicago  shows : 
that  most  of  the  so-called  first  offenders  are  really  old  crimi- 
nals ;  that  most  of  them  are  mentally  defective;  and  that  their 
parents  were  also  mentally  deficient. 

21.  Experts  are  now  agreed  that  feeble-mindedness  is  re- 
sponsible for  the  vast  majority  of  juvenile  delinquencies. 


FEEBLE-MINDEDNESS  IN  RELATION  TO  VICE 
AND  POVERTY 

IN  THE  preceding  chapters  the  relationship  of  feeble-mind- 
edness  was  discussed  in  regard  to  delinquency  in  general, 
but  more  in  particular  with  reference  to  crime  and  criminals. 
In  this  chapter  we  will  consider  mental  def  ectiveness  more  as 
it  is  concerned  in  vice,  inebriety,  poverty,  etc.  Let  us  first 
consider  that  some  of  our  delinquents  are  merely  "  back- 
ward ;  "  not  all  our  misfits  are  clearly  feeble-minded. 

t  THE  BACKWARD  INDIVIDUAL 

Not  all  persons  who  fail  to  pass  certain  arbitrary  and  pre- 
arranged mental  tests  are  to  be  classed  as  feeble-minded  — 
some  of  those  individuals  are  merely  backward  or  uneducated. 
Wallin  contends  that  many  cases  showing  feeble-mindedness 
by  the  Binet-Simon  tests,  would  on  more  careful  and  pains- 
taking examination  prove  to  be  merely  backward,  and  cites 
numerous  actual  cases  in  proof,  of  which  the  following  is  a 
typical  example : 

Mr.  A.,  65  years  old,  faculties  well  preserved,  attended 
school  only  about  three  years  in  the  aggregate,  successively 
a  farmer  and  business  man,  now  partly  retired  on  a  compe- 
tency of  $30,000  (after  considerable  financial  reverses  from  a 
fire)  for  ten  years  president  of  the  board  of  education  in 
a  town  of  700,  superintendent  or  assistant  superintendent  of 
a  Sunday  school  for  about  thirty  years,  bank  director,  raised 
and  educated  a  family  of  nine  children,  all  normal;  one  (Ph. 
D.)  engaged  in  scientific  research,  one  assistant  professor 

299 


300  RACE  DECADENCE 

in  a  state  agricultural  school,  one  assistant  professor  in  a 
medical  school,  one  (now  deceased)  a  former  music  teacher 
and  organist,  graduate  of  a  musical  conservatory,  one  a  grad- 
uate of  the  normal  department  of  a  college,  one  a  graduate 
nurse,  two  engaged  in  a  large  retail  business,  one  holds  a 
clerical  position,  all  high-school  graduates  and  all  except  one, 
one-time  students  in  colleges  and  universities,  failed  on  all 
the  new  Binet  tests  except  six  digits  and  suggestion  lines 
(almost  passed  the  central  thought  test). 

This  man,  measured  by  the  automatic  and  arbitrary  stand- 
ards which  are  commonly  followed,  would  be  classed  as 
hopelessly  feeble-minded  and  should  have  been  committed  to 
an  institution  for  the  feeble-minded  long  ago  as  a  "  mental 
defective."  But  is  there  anyone  who  has  the  temerity,  in 
spite  of  the  Binet  "  proof  "  to  maintain,  in  view  of  this  man's 
personal,  social,  and  commercial  record,  and  the  record  of 
his  family,  that  he  has  been  a  social  and  mental  misfit,  and 
an  undesirable  citizen,  and  should,  therefore,  have  been  re- 
strained from  propagation  because  of  the  mental  deficiency? 
(His  wife  is  still  less  intelligent.)  It  is  a  safe  guess  that 
there  are  hundreds  of  thousands  like  him  throughout  the 
country,  no  more  intellectual  and  no  better  educated,  but 
equally  successful  and  prudent  in  the  management  of  their 
affairs.  Had  he  been  a  criminal  when  he  was  tested,  those 
who  implicitly  follow  these  standards  would  have  offered 
testimony  under  oath  that  he  was  feeble-minded  and  unable, 
to  distinguish  between  right  and  wrong,  or  unable  to  choose 
the  right  and  avoid  the  wrong.  This  case  illustrates  how 
easy  such  a  mistake  could  be  made. 

Most  "  middle-grade  "  morons  should  be  classed  as  back- 
ward or  borderline.  It  is  probable  that  there  are  ten-year 
persons  whom  we  are  justified  in  classing  as  socially  weak  — 
or  sociopathic,  to  borrow  Hickson's  term  —  rather  than 
feeble-minded.  It  should  be  emphasized  that  feeble-minded- 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  301 

ness  is  only  one  cause  of  social  weakness,  incompetency,  and 
irresponsibility. 

This  view  is  also  corroborated  by  Healy,  who  says: 
"  We  must  confess  to  a  lack  of  sympathy  with  the  highly 
colored  statements  and  immaturely  considered  statistics  that 
have  been  in  the  last  few  years  placed  before  the  public.  The 
realities  of  the  situation  are  bad  enough ;  there  is  no  need  of 
any  propaganda  by  exaggeration." 

In  distinguishing  between  mental  defectiveness  and  back- 
wardness, Wallin  insists  that  the  following  points  must  be 
kept  in  mind : 

1.  If  is  not  possible  in  a  large  number  of  cases  of  both 
children  and  adults  to  make  accurate  and  adequate  individual 
mental  diagnosis,  or  to  make  a  mental  classification  of  a  group 
of  individuals  merely  by  rule-of-thumb  procedure  involving 
the  use  of  the  present  scale  of  Binet-Simon  tests  and  certain 
arbitrarily  proposed  absolute  standards  of  retardation. 

2.  The  function  of  tests  in  clinical  psychology  is  the  same 
as  the  function  of  tests  in  medicine.    They  are  standardized 
tools  by  means  of  which  the  trained  psychologist  or  trained 
physician  may  work  more  skilfully.     They  enable  him  to 
observe  under  controlled,  standardized,  objective  conditions; 
they  render  his  results  comparable  with  the  observations  of 
others,  and  make  it  possible  for  him  to  interpret  his  findings 
in  terms  of  average  normals.    Even  the  best  tests  in  psychol- 
ogy, however,  should  be  regarded  merely  as  aids  to  assist  in 
the  examining  psychologist  to  a  guarded  diagnosis. 

3.  The  standards  which  have  been  most  frequently  used  in 
this  country  during  the  last  few  years  yield  entirely  too  high 
a  percentage  of  feeble-mindedness.    There  was  a  time  when 
the  estimates  of  the  number  of  feeble-minded  in  the  general 
population,  in  the  schools,  courts,  prisons,  and  reformatories, 
was  too  conservative.     But  the  pendulum  has  now  swung 
to  the  opposite  extreme.    Feeble-mindedness  has  become  the 


302  RACE  DECADENCE 

Nemesis  of  our  times.  We  are  now  told  that  at  least  3  per 
cent  of  our  elementary-school  children  are  feeble-minded,  that 
at  least  half  the  delinquents  are  feeble-minded  —  the  figures 
given  are  sometimes  nearer  100  per  cent  than  50  per  cent  — 
and  that  most  of  our  social  ills  are  due  to  feeble-mindedness. 
We  believe  that  feeble-mindedness  is  one  cause,  a  very  im- 
portant cause,  but  still  only  one  cause,  of  our  social  difficul- 
ties. We  believe  that  the  number  of  feeble-minded  children 
in  the  schools  varies  from  less  than  one-half  of  I  per  cent  to 
less  than  i  per  cent,  instead  of  3  per  cent  or  more,  while  the 
number  of  feeble-minded  in  courts,  reformatories,  assignation 
houses,  and  penal  institutions  varies  from  about  10  per  cent 
to  25  per  cent  instead  of  from  50  per  cent  to  97  per  cent. 

4.  The  term  "  feeble-mindedness  "  should  be  more  sharply 
delimited.  From  the  standpoint  of  intelligence  the  limiting 
line  should  be  drawn  at  the  point  where  the  intelligence  is  so 
deficient  that  an  older  adolescent  or  adult  is  just  barely  not 
able  to  make  his  living  —  cannot  maintain  an  independent 
existence  at  the  simplest  form  of  work  afforded  by  the  com- 
munity. The  point  will  vary  with,  the  community  and  the 
individual,  but  the  variation  should  not  be  unduly  extended 
when  the  individual  happens  to  be  a  delinquent.  There  are 
other  reasons  for  social  irresponsibility  than  feeble-minded- 
ness. 

FEEBLE-MINDEDNESS  AND  PROSTITUTION 

The  New  Hampshire  Children's  Commission  reports  that 
"  any  child  has  been  considered  feeble-minded  who  is  three 
years  or  more  retarded  in  intelligence.  Such  retardation 
could  be  determined  accurately  for  all  institutional  cases  by 
the  use  of  the  Binet-Simon  measuring  scale."  The  com- 
mission also  wishes  to  emphasize  strongly  the  fact  that  its 
figures,  so  far  as  they  go,  underestimate  rather  than  over- 
estimate the  situation.  They  have  erred,  if  at  all,  on  the  side 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  303 

of  conservatism.  "  In  a  study  of  424  harlots  80  per  cent  were 
found  to  be  distinctly  defective,  their  mental  age  seldom 
exceeding  12  years.  Of  some  studies  made  in  juvenile  courts, 
numbering  1,487  cases  —  61  per  cent  were  found  feeble- 
minded, their  mental  age  averaging  from  7^2  to  1 1  years." 

There  is  no  reliable  way  of  determining  what  per  cent  of 
prostitutes  of  either  the  public  or  clandestine  sort  are  men- 
tally defective ;  for  it  is  a  well-known  fact  that  such  individ- 
uals are  sometimes  morally  defective  without  showing  the 
least  trace  of  being  feeble-minded.  Twenty-five  years  of 
observation  and  study  of  unfortunate  women  have  convinced 
Dr.  Lena  K.  Sadler  that  about  60  per  cent  of  prostitutes  are 
mentally  deficient ;  about  25  per  cent  are  normal  mentally  as 
regards  intelligence,  but  have  decided  moral  defects,  while 
about  15  per  cent  of  these  women  are  fairly  normal  women 
botfy  mentally  and  morally  as  regards  their  intellectual  equip- 
ment, but  who  for  sundry  reasons  choose  to  live  an  immoral 
life.  Very  few  of  this  latter  class  permanently  follow  pros- 
titution —  it  is  in  many  of  these  cases  only  a  temporary 
thing. 

Again  it  is  the  author's  belief,  that  it  is  the  mental  defect  — 
f  eeble-mindedness  —  that  is  hereditary  and  not  the  tendency 
(directly)  towards  prostitution  or  sexual  immorality.  The 
daughter  of  a  prostitute  does  not  inherit  her  mother's  tend- 
ency—  directly  —  to  prostitution,  only  her  mother's  mental 
defect,  and  thus  finds  herself  led  into  an  evil  life  for  exactly 
the  same  reason  that  the  feeble-minded  mother  so  quickly 
took  the  path  of  least  resistance  in  the  social  struggles  and 
the  moral  battle  of  life. 

Thus  there  is  reason  to  believe  that  from  a  third  to  two- 
thirds  of  the  prostitutes  of  American  cities  are  feeble-minded. 
They  should  be  committed  to  institutions  for  the  feeble- 
minded and  kept  there. 

Physical  examination  of  wayward  girls  and  women  should 


304  RACE  DECADENCE 

be  undertaken  by  a  skilful  woman  physician.  Gynecological 
anomalies  and  ailments  are  frequent  conditions  of  grave 
causative  importance,  and  should  be  carefully  studied  and 
remedied.  In  those  places  where  a  competent  woman  physi- 
cian is  not  available,  the  work  may  be  done,  as  in  private 
practice,  with  a  nurse  always  present. 

Diseases  and  other  defective  conditions  of  the  genito- 
urinary system,  and  syphilis  being  present  in  proportionately 
such  a  large  number  of  offenders,  and  leading  by  local  irrita- 
tion and  by  deteriorative  conditions  almost  directly  to  the 
production  of  further  misconduct,  call  for  much  attention 
and  treatment. 

Examination  of  girls  for  virginity  as  a  basis  for  their 
moral  classification  is,  Healy  thinks,  to  be  greatly  deprecated. 

We  have  spoken  of  the  boy  truant,  the  beginning  of  whose 
downfall  seems  traceable  to  eyestrain.  But  what  of  the 
girl  truant  ?  Alas,  for  her,  the  streets  hold  even  more  temp- 
tation and  even  greater  degradation. 

Investigation  of  the  history  of  the  inmates  of  the  homes  for 
fallen  women  reveals  a  vast  amount  of  eyestrain  and  other 
abnormal  physical  conditions. 

ILLEGITIMATE  BIRTHS 

Although  the  available  statistics  are  meager,  an  attempt 
was  made  by  the  Census  Bureau  to  approximate  roughly  the^ 
total  number  of  illegitimate  births  in  the  United  States  each 
year.  It  was1  impractical  to  arrive  at  such  an  estimate  by 
the  method  based  on  the  total  number  of  live  births  in  the 
United  States,  since  incomplete  birth  registration  makes  it 
impossible  to  obtain,  for  the  country  as  a  whole,  statistics 
having  any  degree  of  accuracy.  Hence,  the  estimate  was 
based  on  the  number  of  single,  widowed,  and  divorced  women 
of  childbearing  age.  In  the  United  States  in  1915  the  esti- 
mated number  of  single,  widowed,  and  divorced  white  women 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  305 

15  to  44  years  of  age  was  8,769,000.!  In  the  sixteen  states 
for  which  figures  of  illegitimate  births  were  obtained  the  rate 
per  1,000  single,  widowed,  and  divorced  white  women  of 
childbearing  age  may  be  estimated  as  at  least  3.7.2  Applying 
this  ratio  to  the  estimated  population  given  above  gives  32,400 
as  an  estimated  number  of  illegitimate  white  births  in  the 
United  States  each  year.  It  must,  of  course,  be  remembered 
that  this  figure  is  an  estimate  based  on  only  part  of  the  coun- 
try :  it  is  improbable,  however,  that  the  true  figure  is  below 
it.  Indeed  it  may  safely  be  considered  as  a  minimum  esti- 
mate because  of  incompleteness  of  birth  registration,  and 
erroneous  registration  of  illegitimate  as  legitimate  births. 

Because  of  the  recognized  inadequacy  of  birth  registration 
in  a  considerable  part  of  the  United  States,  another  estimate 
was  made,  based  on  data  from  states  included  in  the  birth 
registration  area  in  1915.  By  the  method  described  above 
the^rate  for  white  unmarried  women  of  childbearing  age  in 
these  states  may  be  estimated  as  4-3  This  rate  applied  to  the 

1  The   number   of   single,   widowed,   and   divorced   white   women 
15  to  44  years  of  age  on  July  I,  1915,  was  estimated  by  projecting 
the  annual  increase  in  this  group  between  1900  and  1910,  using  the 
arithmetical    method.     Strictly    speaking,    the    figures    for    "  white 
women  "  refer  to  women  of  all  races  other  than  Negro.    The  figure 
8,769,000  includes  approximately  0.2  per  cent  of  Indians,  Chinese, 
and  Japanese. 

2  The  rate  per  1,000  white  and  Negro  women  in  the  group  specified, 
exclusive  of  the  Negro  women  in  two  states,  was  found  to  be  4.3. 

The  rate  per  1,000  white  women  in  this  group  can  be  found  by 
assuming,  in  the  absence,  for  most  of  the  states,  of  illegitimate 
births  classified  by  color,  that  the  ratio  between  the  white  and  Negro 
illegitimate  birth-rates  was  the  same  as  that  in  the  area  of  good 
birth  registration,  Maryland  and  Philadelphia  combined,  where 
illegitimate  births  are  classified  by  color.  (Maryland  was  not  in  the 
birth  registration  area  in  1915  but  was  admitted  in  1916.)  Applying 
this  ratio  to  the  respective  white  and  Negro  populations  in  the  group 
specified  results  in  the  figure  of  3.7  for  the  white  unmarried  female 
population  of  childbearing  age. 

3  The  rate  per  1,000  white  and  Negro  women  in  the  group  specified 
was    4.6;    the    correction    has    been   made    on   the    same    basis   as 
described  in  note  2. 


306  RACE  DECADENCE 

number  of  single,  widowed,  and  divorced  white  women  of 
childbearing  age  in  the  United  States,  gives  a  total  of  35,100 
illegitimate  white  births.  It  must  be  borne  in  mind  that  states 
in  the  birth  registration  area  have  a  disproportionate  urban 
population  among  which  the  illegitimate  birth-rate  is  high. 
Nevertheless,  this  figure  may  be  regarded  as  an  understate- 
ment because  of  errors  and  omissions  of  registration  of  ille- 
gitimate births  even  in  states  included  in  the  birth-registration 
area.1 

FEEBLE-MINDEDNESS  AND  POVERTY 

There  is  a  direct  connection  between  hereditary  feeble- 
mindedness and  such  social  problems  as  poverty,  drunkenness, 
drug  addiction,  and  other  phases  of  delinquency  and  ne'er- 
do-well-ism.  (See  Fig.  17.) 

Poverty  cannot  be  banished  from  our  present-day  civiliza- 
tion as  long  as  f  eeble-mindedness  is  slowly  increasing  among 
the  general  population.  These  mental  defectives  cannot  com- 
pete with  their  more  normal  and  energetic  fellows  in  the 
struggle  for  existence.  The  higher  grade  of  defectives  turn 
criminal  or  immoral  and  the  lower  grades  gravitate  to  the 
poorfarm  or  other  institutions  for  the  feeble-minded. 

Drunkenness  and  drug  addiction  result  from  many  and 
varied  influences  —  both  physical  and  mental  —  but  as  a 
class,  the  victims  of  narcotism  are  neurotic,  and  constitu- 
tionally inferior,  if  not  out-and-out  feeble-minded.  While 


1  A  careful  study  of  records  of  social  agencies  in  Boston  added 
one-eighth  to  the  number  of  illegitimate  births  registered  as  such 
in  the  city.  Similar  estimates  for  Negroes  would  be  subject  to  a 
much  greater  percentage  of  error  than  are  estimates  for  whites, 
first,  because  of  inadequate  registration  in  areas  where  the  Negro 
population  is  largest,  and  secondly,  because  of  special  conditions 
affecting  Negroes.  Such  an  estimate,  if  made,  should  of  course  be 
accompanied  by  a  full  discussion  of  the  history  of  the  problem  and 
of  the  difficulties  involved  in  setting  up  new  standards  of  family 
morality  in  place  of  those  existing  under  slavery  conditions. 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  307 

this  is  not  true  of  all,  it  is  true  of  the  vast  majority  of  these 
habitues  of  alcohol  and  dope.  Some  unfortunates  are  nervous 
as  a  result  of  the  use  of  alcohol  and  narcotics ;  but  the  greater 
number  fall  victims  to  use  of  the  drug  because  they  are  in- 
herently neurotic  —  because  they  are  mentally  inferior  and 
defective  —  because  they  come  into  this  world  blasted  — 
feeble-minded. 

It  is  certain  that  many  of  the  pauper  class,  which  fill  up 
our  almshouses  are  similarly  deficient.  Indeed,  the  census 
of  1910  discovered  the  fact  that  of  84,198  paupers  in  institu- 
tions on  the  first  of  January  in  that  year,  13,238  were  feeble- 
minded, 3,518  insane,  2,202  epileptic,' 918  deaf-mute,  3,375 
blind,  13,753  crippled,  maimed,  or  deformed.  A  total  of  63.7 
per  cent  of  the  whole  had  some  serious  physical  or  mental 
defect.  Obviously,  most  of  these  would  be  taken  care  of 
under  some  other  heading,  in  the  program  of  restrictive 
eugenics.  While  paupers  should  be  prohibited  from  reproduc- 
tion as  long  as  they  are  in  state  custody,  careful  and  just 
discrimination  is  necessary  in  the  treatment  of  those  whose 
condition  is  due  more  to  environment  than  heredity. 

Pauperism  is  a  result  of  a  complex,  of  causes.  On  one 
side  it  is  mainly  environmental  in  origin  as,  for  instance,  in 
the  case  when  a  sudden  accident,  like  death  of  the  father, 
leaves  a  widow  and  family  of  children  without  means  of  live- 
lihood, or  a  prolonged  disease  of  the  wage-earner  exhausts 
savings. 

In  the  larger  pedigrees  of  the  Jukes  and  Zero  families  more 
definite  data  as  to  inheritance  of  some  of  the  elements  of  pov- 
erty can  be  gained.  Let  us  take  "  shiftlessness  "  as  an  im- 
portant element  in  poverty.  Then  classifying  all  persons  in 
these  two  families  as  very  shiftless,  somewhat  shiftless,  and 
industrious,  the  following  conclusions  are  reached.  When 
both  parents  are  very  shiftless  practically  all  children  are 


30&  RACE  DECADENCE 

"  very  shiftless  "  or  "  somewhat  shiftless."  Out  of  62  off- 
spring, 3  are  given  as  "  industrious  "  or  about  5  per  cent. 
When  both  parents  are  shiftless  in  some  degree  about  15  per 
cent  of  the  known  offspring  are  recorded  as  industrious. 
When  one  parent  is  more  or  less  shiftless  while  the  other  is 
industrious  only  about  10  per  cent  of  the  children  are  "  very 
shiftless."  It  is  probable  that  both  shiftlessness  and  lack  of 
physical  energy  are  due  to  the  absence  of  something  which 
can  be  got  back  into  the  offspring  only  by  mating  with  supe- 
rior stock.  The  fundamental  cause  of  pauperism  is  to  be 
found  in  hereditary  tendencies. 

The  last  census  of  paupers  in  the  United  States  —  those 
residing  in  almshouses  —  gave  the  total  of  this  class  as  84,- 
198.  There  are  undoubtedly  considerably  over  100,000  of 
this  class  in  this  country.  The  distribution  of  paupers  as 
regards  age,  nativity,  etc.,  is  shown  by  Table  No.  n,  Ap- 
pendix A. 

CHILDREN   BORN   OF  PAUPER   MOTHERS 

It  is  astounding  to  contemplate  the  number  of  children 
which  are  annually  born  of  feeble-minded  and  pauper  par- 
ents in  this  country.  In  proof  of  this  please  note  that  in 
1910  the  report  of  the  Census  Bureau  indicated  that  the  fe- 
male paupers  in  the  almshouses  of  the  United  States  are 
shown  to  have  borne  18,448  children.  For  details  see  Ap- 
pendix A,  Table  No.  12. 

It  should  be  further  noted,  in  this  connection,  that  the 
census  reports  show  that  in  one  year  1,107  illegitimate  babies 
were  born  to  mothers  confined  in  the  various  almshouses  of 
this  country.  For  details  see  Table  No.  13,  Appendix  A. 

INEBRIETY 

Regarding  chronic  inebriety  and  its  relation  to  heredity, 
Johnson  says: 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  309 

In  a  consideration  of  the  chronic  inebriate,  the  problem  of  environ- 
mental influences  is  again  met  in  an  acute  form,  aggravated  by  the 
venom  of  controversy  engendered  by  bigotry  and  self-interest. 
That  many  chronic  inebriates  owe  their  condition  almost  wholly  to 
heredity,  and  are  likely  to  leave  offspring  of  the  same  character,  is 
indisputable.  As  to  the  possibility  of  ''reforming"  such  an  in- 
dividual, there  may  be  room  for  a  difference  of  opinion;  as  to  the 
possibility  of  reforming  his  germ-plasm,  there  can  be  none.  Society 
owes  them  the  best  possible  care,  and  part  of  its  care  should  cer- 
tainly be  to  see  that  they  do  not  reproduce  their  kind.  As  to  the 
borderland  cases  —  and  in  the  matter  of  inebriety,  borderland  is 
perhaps  bigger  than  mainland  —  it  is  doubtful  whether  much  direct 
action  can  be  taken  in  the  present  state  of  scientific  knowledge  and 
of  public  sentiment.  Education  of  public  opinion  to  avoid  marriage 
with  drunkards  will  probably  be  the  most  effective  means  of 
procedure. 

There  is  little  doubt  but  that  some  individuals  stupefy 
themselves  with  narcotics  and  thus  appear  to  a  mental  disad- 
vantage —  they  seem  to  grow  more  feeble-minded  as  a  result 
of  flrink ;  while  still  others  drink  so  inordinately  merely  be- 
cause they  are  inherently  weak-minded  —  they  lack  the  power 
to  resist  the  charm  of  drink  and  other  narcotics. 

DEFECTIVES  AND  INDUSTRIAL  ACCIDENTS 

In  the  60,000  factories  of  New  York  2,000,000  workers  are 
employed,  of  whom  approximately  1,600,000  are  foreign 
born. 

During  the  year  1915,  the  first  year  in  which  the  Work- 
men's Compensation  Law  became  effective  in  the  state  of 
New  York,  there  were  225,391  reported  accidents;  in  1916 
there  were  273,385;  in  1917,  313,406;  and  in  1918,  286,771, 
costing  $11,500,000  or  $40,000  a  day,  and  representing  an 
average  of  274,763  each  year  —  practically  as  great  a  number 
per  year  in  that  one  state  as  the  entire  national  army  casual- 
ties during  the  World  War. 

With  the  productive  capacity  of  a  nation  reduced,  and  its 
dependent  and  defective  classes  multiplying  in  such  alarming 


310  RACE  DECADENCE 

proportions  the  tax  upon  its  resources  becomes  inequitable. 
In  Pennsylvania,  the  state  receiving  the  second  largest  quota 
of  immigration,  accident  casualties  are  not  only  voluminous 
but  of  the  direst  nature.  During  the  past  year  the  New  York 
State  Industrial  Commission  has  investigated  cases  involving- 
actions  in  which  the  total  amount  sued  for  was  approximately 
$1,500,000.  Settlements  were  obtained  amounting  to  only 
about  $25,000,  in  many  cases  leaving  behind  derelicts  as  help- 
less as  any  of  the  survivors  of  the  war. 

Five  years  ago  the  coming  and  going,  the  hiring  and  firing, 
of  the  alien  worker  was  little  regarded;  Ellis  Island  could 
produce  many  more  where  he  came  from.  Five  years  ago 
the  economic  aspect  of  uncompensated  accident  casualties  was 
considered  of  small  importance.  There  is  no  way  of  definitely 
knowing  what  percentage  of  our  industrial  accidents  are  due 
to  mental  defectiveness  on  the  part  of  the  workers;  but 
there  is  little  or  no  doubt  that  a  very  considerable  number  of 
such  mishaps  are  due  to  stupidity  and  dullness,  which  is  akin 
to  feeble-mindedness  or  mental  backwardness  of  some  de- 
gree. Feeble-mindedness  goes  a  long  way  towards  explain- 
ing much  of  the  inefficiency  of  the  nation. 

GETTING  THE  CART  BEFORE  THE  HORSE 

Is  poverty  a  cause  of  crime?  Are  crime  and  immorality 
more  largely  due  to  inherent  tendency  or  to  the  influence  of 
bad  example  and  evil  surroundings  ?  Wherever  there  is  some 
relation  between  the  alleged  cause  and  the  result,  one  feels 
that  these  explanations  are  based  on  the  logical  error,  and 
that  the  cart  is  often  put  before  the  horse.  The  very  multi- 
plicity of  explanations  shows  their  inadequacy.  There  is  a 
more  fundamental  explanation  for  these  non-social  traits 
than  any  of  those  that  are  usually  ascribed. 

One  author  sums  up  the  "  values  "  and  "  relationships  " 
of  this  problem  in  the  following  statement : 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  311 

First  of  all  we  can  see  clearly  that  the  traits  that  cause  so  much 
trouble  are  "  unfortunate  "  or  "  bad  "  only  in  relation  to  our  society, 
i.  e.,  relatively,  not  absolutely.  Lack  of  speech,  inability  to  care  for 
the  person  or  to  respond  in  the  conventional  fashion  to  the  calls 
of  nature,  failure  to  learn  the  art  of  dressing  and  undressing, 
inability  to  count,  entire  lack  of  ambition  beyond  getting  a  meal, 
abject  slothfulness,  love  of  sitting  by  the  hour  picking  at  a  piece 
of  cloth,  these  are  unfortunate  mental  traits  for  a  twentieth- 
century  citizen  but  they  constitute  a  first-rate  mental  equipment  for 
our  remote  apelike  ancestors,  nor  do  we  pity  infants  who  in- 
variably have  them.  So  likewise  with  crimes :  the  acts,  of  taking 
and  keeping  loose  articles,  of  tearing  away  obstructions  to  get  at 
something  desired,  of  picking  valuables  out  of  holes  and  pockets, 
of  assaulting  a  neighbor  who  has  caused  pain  or  who  is  in  the  way, 
of  deserting  family  and  other  relatives,  of  promiscuous  sexual  rela- 
tions, these  are  crimes  for  a  twentieth-century  citizen,  but  they  were 
the  normal  acts  and  customs  of  our  remote  ancestors,  and  excepting 
the  last,  they  are  so  common  with  infants  that  we  laugh  when  they 
do  such  things.  In  a  word  the  traits  of  the  feeble-minded  and  the 
criminalistic  individual  are  alike  normal  traits  for  infants  of  today 
and  adults  in  the  earlier  stages  of  man's  evolution.  There  is  an 
apiorism  that  biologists  use  which  is  apt  here :  "  Ontogeny  re- 
capitulates phylogeny,"  which  means  that  the  individual  in  its  develop- 
ment passes  through  the  stages  like  those  the  race  has  traversed 
in  its  evolution.  The  infant  represents  the  apelike  stage. 

THE  SOLUTION  OF  THE  PROBLEM 

What  are  we  going  to  do  about  it?  What  shall  we  do 
with  the  criminals  and  delinquent  classes  ?  First  we  must  by 
painstaking  effort  and  scientific  methods  separate  these  un- 
fortunates into  two  classes  —  those  who  have  gone  wrong 
because  of  hereditary  defects  —  and  those  who  have  stum- 
bled because  of  backwardness  or  unfavorable  environment. 

Regarding  the  first  class  —  those  with  defective  mentality 
of  hereditary  origin  —  there  is  but  one  thing  to  recommend : 
that  is,  to  substitute  some  sort  of  regime  which  will  effectually 
prevent  reproduction  —  either  segregation  or  sterilization. 

Regarding  the  second  class  —  the  doubtful  cases  and  those 
unfortunates  who  are  not  altogether  defective  —  there  are 
a  number  of  things  which  may  prove  of  benefit : 


312  RACE  DECADENCE 

1.  Environment. —  Remove  every  physical  handicap;  im- 
prove the  health ;  give  such  medical  and  surgical  attention  as 
may  be  indicated.    This  must  not  be  taken  to  mean  that  the 
author  subscribes  to  such  foolish  current  teaching  as  is  em- 
bodied in  the  popular  statement  that  "  crime  is  a  disease." 

2.  Punishment. —  Inflict  proper  punishment ;  set  in  opera- 
tion effective  correction.     While  punishment  may  not  be  of 
much  value  to  the  more  defective  classes ;  it  is  of  real  assist- 
ance if  wisely  applied  to  this  group  of  offenders.    It  certainly 
is  the  sincere  opinion  of  many  offenders  that  if  punishment 
were  more  swiftly  and  more  surely  carried  out,  its  deterrent 
effect  would  be  commensurably  greater. 

j.  Detention. —  Irresponsible  individuals  should  not  be  per- 
mitted to  roam  at  will  about  the  country  to  prey  upon  society 
as  the  whim  may  possess  them  from  time  to  time.  There  is 
no  logic  in  turning  loose  an  epileptic  upon  the  public  just 
because  he  is  in  a  reformatory  and  the  authorities  happen  to 
decide  that  he  was  not  "  responsible  for  his  crime." 

4.  Prison  reform. —  Let  us  clean  up  and  reorganize  our 
penal  institutions.  Why  should  a  sojourn  in  some  reforma- 
tory establishment  be  commonly  looked  upon  as  the  surest 
way  to  make  a  confirmed  criminal  out  of  some  young  of- 
fender ? 

After  learning  some  of  the  genetics  of  criminalistic  tend- 
encies, even  sanitation  and  the  physical  features  of  the  build- 
ing where  offenders  are  detained  appear  quite  secondary  in 
importance  to  the  moral  possibilities  of  the  place.  Fortu- 
nately the  equipment  that  maintains  physical  health  conserves 
to  a  certain  extent  the  moral  well-being  of  the  prisoner. 

It  is  no  lack  of  wisdom  that  leads  the  shrewd  policeman 
to  say  to  the  young  offender :  "  You'd  better  keep  out  of  jail, 
because  if  you're  not  a  crook  when  you  go  in,  you  will  be 
when  you  come  out."  What  a  very  strange  anomaly  it  is, 
that  society  should  take  the  person  from  whom  it  desires 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  313 

better  actions,  and  place  him  under  conditions  which  offer 
every  chance  for  the  creation  of  worse  tendencies. 

5.  Mental  and  manual  training. —  Schooling  for  the  mind 
and  training  for  the  hand  —  especially  the  latter  —  are  the 
prime  requisites  for  uplifting  the  more  hopeful  class  of  de- 
linquents.   Maybe  something  can  be  done  to  atone  for  some 
of  the  defects  in  our  educational  and  social  systems  as  re- 
gards these  weaker  members  of  our  commonwealth. 

6.  Play  and  religion. —  We  must  teach  these  individuals 
how  to  have  a  "  good  time  "  without  having  to  become  "  anti- 
social "  in  so  doing.    They  must  be  introduced  to  wholesome 
methods  of  recreation.    Play  is  the  sovereign  remedy  for  the 
"  curable  "  class  of  delinquents. 

Religion  also  has  its  place  in  individual  cases.  There  can 
be  no  doubt  that  it  helps  to  strengthen  the  will  of  some, 
while  it  supplies  the  basis  for  a  "  changed  state  of  mind  "  and 
attitude  on  the  part  of  others.  Many  zealous  Christian 
workers  would  do  more  to  uplift  the  fallen  if  they  had  a 
little  training  in  biology  on  the  one  hand  and  some  under- 
standing of  psychology  on  the  other. 

Offenders  can  never  be  treated  properly  unless  their  prob- 
lems are  understood.  No  machinery  of  court  or  institution, 
however  well  organized,  can  ever  take  the  place  of  deep  hu- 
manistic understanding.  The  girl  put  it  well  who  blurted 
out  to  a  certain  judge,  "  You  and  your  officers  are  here  to  do 
your  duty,  and  I  suppose  you  are  going  to  send  me  away, 
but  before  I  go  I  want  to  tell  you  one  thing;  you  don't  at  all 
understand  me." 

SUMMARY  OF  THE  CHAPTER 

I .  We  are  forced  to  recognize  that  many  a  substantial  and 
prosperous  citizen  might  so  fail  in  passing  certain  set,  arbi- 
trary mental  tests  as  to  fall  under  the  class  of  the  feeble- 
minded. 


314  RACE  DECADENCE 

2.  Most  "  middle-grade "   morons,  like   other  borderline 
cases,  are  easily  confused  with  the  "  backward  "  group.    This 
group  is  also  known  by  the  name  of  "  sociopaths." 

3.  In  studying  mental  subnormality,  we  should  recognize 
that  the  role  of  laboratory  tests  is  similar  to  the  technical 
tests  in  medicine  —  they  are  a  help  towards  diagnosis  —  not 
the  basis  thereof. 

4.  Wallin  thinks  the  estimates  of  3  per  cent  mental  defec- 
tiveness  in  American  school  children  too  high.     He  thinks 
that  our  standards  and  tests  are  not  satisfactory. 

5.  This  author  thinks  we  have  less  than  i  per  cent  mental 
defectives  in  the  schools ;  and  that  only  10  to  25  per  cent  of 
delinquents  are  defective  —  instead  of  50  per  cent  or  more. 

6.  On  the  other  hand  the  New  Hampshire  Children's  Com- 
mission reports  that  in  examining  424*  harlots,  that  80  per 
cent  were  found  distinctly  defective. 

7.  Of  1,487  cases  of  previous  delinquency  studied  in  courts, 
6 1  per  cent  were  found  feeble-minded,  age  tests  averaging 
from  jl/2  to  ii  years. 

8.  Dr.  Lena  K.  Sadler  estimates  prostitutes  as  60  per  cent 
feeble-minded,  25  per  cent  normal,  except  for  moral  defects, 
and  15  per  cent  average  normal. 

9.  The  daughter  of  a  prostitute  does  not  directly  inherit 
her  mother's  tendency  to  immorality,  but  simply  inherits  the 
mother's   feeble-minded  mentality  —  which  always  chooses 
the  path  of  least  resistance. 

10.  All  sexual  delinquents  should  be  subjected  to  a  thor- 
ough-going physical  and  medical  examination  in  addition  to 

the  standard  mental  tests. 

11.  The  Census  Bureau  estimates  that  we  have  over  35,000 
illegitimate  white  babies  born  in  the  United  States  each  year. 

12.  There  appears  to  be  a  direct  connection  between  in- 
herited feeble-mindedness  and  such  social  problems  as  pov- 
erty, drunkenness,  drug  habits,  and  general  ne'er-do-well-ism. 

13.  In  times  of  stress  the  higher  grades  of  defectives  turn 
criminal,  the  middle  grades  gravitate  to  the  poorfarm,  and 
the  lower  grades  to  the  feeble-minded  asylum. 

14.  Twenty-five  per  cent  of  the  paupers  of  this  country 
are  recognized  to  be  out-and-out  feeble-minded  or  insane, 
while  63.7  per  cent  have  some  mental  or  physical  defect. 


FEEBLE-MINDEDNESS,  VICE,  POVERTY  315 

15.  "  Shiftlessness  "  is  a  hereditary  trait  of  character  and 
has  been  most  carefully  worked  out  in  such  families  as  the 
Jukes  and  Zeros. 

16.  There  are  about  100,000  paupers  confined  in  the  alms- 
houses  of  this  country,  not  to  mention  those  subsisting  on 
charity  outside  the  poorhouse. 

17.  During  a  recent  year,  female  paupers  in  almshouses  of 
the  United  States  gave  birth  to  18,448  children. 

1 8.  During  a  single  year  1,107  illegitimate  babies  were 
born  to  defective  mothers  confined  in  the  various  almshouses 
of  this  country. 

19.  While  alcoholism  may  stupefy  the  mind,  the  majority 
of    inebriety    grows    out    of    inherent    weak-mindedness  — 
these  unfortunates  lack  the  power  to  resist  the  charm  of 
drink. 

20.  The   increasing   prevalence   of    feeble-mindedness   is 
undoubtedly  associated  with  the  increasing  number  of  indus- 
trial accidents. 

21.  The  inherently  feeble-minded  commits  acts,  which  his 
fellows  classify  as  crimes ;  but  which  were  entirely  normal  on 
the  part  of  his  remote  ancestors. 

22.  In  dealing  with  all  classes  of  delinquents,  we  must 
recognize  two  classes  —  those  who  are  inherently  defective, 
and  those  who  have  stumbled  because  of  unfavorable  en- 
vironment. 

23.  Our  treatment  of  the  hereditary  delinquent  must  pro- 
vide for  continuous  supervision  and  attention. 

24.  Our  treatment  of  the  environmental  delinquent  must 
provide  for:  the  removal  of  physical  handicaps  and  proper 
punishment  during  detention  in  an  uplifting  atmosphere. 

25.  Both  manual  and  mental  training  would  be  helpful  to 
the  non-hereditary  delinquent,  not  to  mention  the  good  effects 
of  plain  religion. 


CHAPTER  XXII 
BORDERLAND  DEFECTIVES 

IN  ORDER  to  complete  the  picture  of  Race  Decadence 
from  the  mental  and  nervous  standpoints,  we  will,  in  this 
chapter,  present  a  group  of  so-called  "  borderland  "  ailments 
which  are  on  the  whole  hereditary,  but  which  are  not  all  so 
serious  from  the  eugenic  viewpoint  as  the  more  grave  mental 
defects  already  considered. 

In  a  general  way,  these  numerous  inheritable  defects  and 
diseases  follow  the  laws  of  Mendel  just  as  does  feeble- 
mindedness ;  although  we  must  recognize  now  and  then  that 
even  mental  defectiveness  presents  a  case  that  seems  not 
exactly  to  follow  Mendel's  laws.  I  recently  studied  a  family 
of  eight  children,  four  of  whom  were  markedly  defective. 
The  father  and  mother  both  seem  to  be  honest  and  are  fairly 
intelligent  and  reliable  people.  They  absolutely  deny  the  ex- 
istence of  any  mental  defect  on  either  side.  In  neither  family 
has  anyone  been  in  a  public  institution.  All  brothers  and  sis- 
ters of  the  father  and  mother  are  self-supporting,  and  their 
few  children  are  all  said  to  be  normal.  We  can  conceive  of 
no  reason  why  these  parents  would  want  to  mislead  us,  in 
view  of  their  otherwise  frank  and  full  statement  of  all  the 
family  history.  Certainly  if  one  were  to  go  by  Mendelian 
ratios,  we  would  expect  a  trait  which  shows  itself  in  four 
out  of  eight  children  to  be  discoverable  somewhere  in  the 
ancestral  history,  and  therefore  to  be  more  or  less  well  known 
as  a  family  trait  or  characteristic. 

316 


BORDERLAND  DEFECTIVES  317 

MATERNAL  IMPRESSIONS 

Many  of  the  defects  noted  in  this  chapter  will  be  con- 
nected in  the  reader's  mind  with  the  old  subject  of  "  birth- 
marks," "  maternal  impressions,"  and  "  prenatal  influences." 
The  effect  of  so-called  prenatal  influences  or  maternal  impres- 
sions (some  condition  or  activity  of  the  mother's  mind)  in 
influencing  in  any  way  the  mind  or  body  of  the  unborn 
child  has  yet  to  be  proven.  This  is  in  no  wise  controverting 
the  well-known  serious  effects  of  disease,  sorrow,  or  worry 
shown  in  maternal  nutritional  disturbance,  or  the  effects  of 
lack  of  food,  poisoning,  etc.,  during  pregnancy. 

Science  does  not  credit  the  belief  that  fright  or  other 
strong  emotion  can  frighten  an  expectant  mother  and  thereby 
mark  or  disfigure  the  unborn  child.  Some  authorities  main- 
tain that  the  mother  can  influence  the  mental  and  physical 
development  of  her  child  by  some  derangement  in  the  internal 
secretions  of  the  ductless  gland  system  of  her  own  body.  But 
this  is  not  the  place  for  the  full  discussion  of  this  most  in- 
teresting subject.  More  attention  will  be  given  it  at  another 
time ;  meantime  we  should  rest  assured  that  the  defects  noted 
in  this  chapter  are  true  hereditary  defects  and  that  they  have 
no  connection  with  the  question  of  "  maternal  impressions." 

In  this  class  of  minor  defectives  are  those  who  are  ger- 
minally  physical  weaklings  or  deformed,  those  born  with  a 
hereditary  diathesis  or  predisposition  toward  some  serious 
disease  (e.  g.,  Huntington's  chorea),  and  those  with  some 
gross  defect  of  the  organs  of  special  sense.  The  germinally 
blind  and  deaf  will  particularly  occur  to  mind  in  the  latter 
connection.  Cases  falling  in  this  category  demand  careful 
scrutiny  by  biological  and  psychological  experts,  before  any 
action  can  be  taken  in  the  interest  of  eugenics ;  in  many  cases 
the  affected  individual  himself  will  be  glad  to  cooperate  with 
society  by  remaining  celibate  or  by  the  practice  of  birth  con- 


318  RACE  DECADENCE 

trol,  to  the  ena  of  leaving  no  offspring  to  bear  what  he  has 
borne. 

ABNORMAL  PHYSICAL  CONDITIONS 

Among  the  various  abnormal  physical  conditions  which 

may  contribute  to  delinquency,  the  study  of  a  group  in  the 

psychopathic  department  of  the  Chicago  Municipal  Court 
gives  the  following  as  the  leading  possible  physical  factors  or 
causes : 

Major  Minor 

General  excessive  overdevelopment  for  age 4  33 

Marked  overdevelopment  of  sex  characteristics  for  age    5  18 

Puberty  markedly   premature 9  53 

Excessively  poor  general  development 7  42 

Very  poor  nutrition 3  24 

Puberty  much   delayed 8 

General  poor  physical  condition 5  23 

Anemia   5  7 

Heart  disease   I  6 

Excessive  enlargement  of  thyroid I  2 

Diseases  or  defects  in  nose  and  throat 10  41 

Excessive  carious  teeth 3  19 

Marked  defective  vision 13  72 

Marked   defective  hearing I  13 

Phimosis  5  5 

Local  irritative  conditions  of  genitals I  5 

Venereal  disease   I 

Pregnancy I 

Ptosis   I 

Defective  control  of  bladder 3 

Deaf-mutism   I  i 

Stammering  in  excess 2  4 

Headaches  in  excess 3  n 

General  nervous  manifestations  (neurotic  types) 2  15 

Gynecological  ailment  I 

Chorea   3 

Epilepsy    I 

Ringworm      I 

Tuberculosis    2 

Recent  injury I 

Migraine  I 

Boyish  type  of  physique  in  girl I 


BORDERLAND  DEFECTIVES  319 

The  director  of  the  Psychopathic  Laboratory  comments  as 
follows : 

It  is  only  when  physical  conditions  have  appeared  themselves 
directly  as  causes,  irrespective  of  mental  conditions,  that  we  have 
included  them  in  the  above  enumeration.  For  example,  epilepsy  was 
a  factor  in  the  delinquency  of  one  individual  who  did  not  have  any 
accompanying  mental  symptoms,  and  thus  it  counted  as  a  physical 
cause.  Then  ringworm  caused  the  rejection  of  a  boy  from  school 
and  his  consequent  life  with  bad  street  companions.  Of  course  in 
many  more  cases  than  given  above,  carious  teeth  were  found,  but 
only  in  twenty-two  instances  could  the  condition  be  counted  in  any 
way  related  to  the  delinquency.  It  is  the  same  with  defective  vision 
and  other  conditions.  The  number  of  instances  in  which  phimosis 
was  a  factor  will  to  some  appear  very  small,  but  it  is  as  we  have 
found  it  with  very  careful  observation.  Venereal  disease  is  very 
common  among  the  young  women  we  have  seen,  but  in  itself  could 
only  be  regarded  as  a  causative  factor  in  one  case.  Pregnancy  once 
was  a  factor  when  there  was  an  accompanying  minor  psychosis. 
Possession  of  a  boyish  type  of  physique  was  an  incentive  in  one 
case*to  the  girl  pursuing  a  life  of  adventure,  suitably  attired  as  a 
boy/ 

That  the  so-called  stigmata  of  degeneracy  play  but  a  small 
part  in  identifying  the  criminal  type  is  shown  by  the  fact 
that  in  1,000  cases  of  criminals  examined  and  reported  by 
Healy,  only  133  showed  these  stigmata  in  any  form. 

Anomalies  of  external  ear 67 

Anomalies  of  palate  and  jaws 63 

Anomalies  of  shape  of  head  (including  facial  asym- 
metry)      55 

Anomalies  of  teeth 5 

Body  asymmetry   5 

Anomalies  of  eye 4 

Gynecomastia  2 

Anomalies  of  hands : 2 

Supernumerary  mammae I 

It  appears  that  if  the  cases  of  mental  abnormality  are 
taken  out  of  a  criminal  series,  the  proportion  of  marked  stig- 
mata will  be  little,  if  any,  larger  than  in  the  general  popula- 
tion. 


320  RACE  DECADENCE 

DEMENTIA  PRAECOX 

This  is  a  form  of  inherited  insanity  or  nervous  disorder 
of  a  very  grave  character,  usually  making  its  appearance  in 
the  early  years  of  adolescence,  but  sometimes  not  appearing 
for  many  years  subsequent.  At  present,  it  must  be  regarded 
in  general  as  an  incurable  disorder.  Heredity  has  consider- 
able to  do  with  it,  though  it  does  appear,  like  Mongolian 
idiocy,  now  and  then  in  families  which  represent  fairly  good 
stock,  and  its  hereditary  nature  is  not  so  fully  understood  as 
that  of  some  other  insanities. 

It  may  be  possible  that  dementia  praecox,  in  common  with 
numerous  other  nervous  disorders  of  doubtful  nature  and 
origin,  is  largely  due  to  disturbances  of  the  internal  glandular 
system  of  the  body.  At  least  it  is  to  be  hoped  that  additional 
research  and  new  discoveries  in  this  field,  may  offer  us  at 
least  some  hope  of  affording  relief  to  these  unfortunate  suf- 
ferers. 

Sajous  states  that  this  disorder  is  partly  caused  by  de- 
creased secretion  of  the  thymus  gland  too  early  at  puberty, 
that  is, 

....  before  the  completion  of  the  development  of  the  brain.  The 
thymus  being  also  a  participant  in  the  antitoxic  processes  of  the 
body,  with  the  thyroid  and  adrenals,  its  untimely  deficiency  entails 
likewise  the  accumulation  of  toxics  which  produce  the  morbid 
mental  phenomena.  Kraepelin,  Tyron  and  Pierce  Clark,  Benedik 
and  Deak,  Laignel-Lavastine,  and  others  have  held  that  the  disease 
was  of  toxic  origin  —  again,  however,  without  accounting  for  the 
process. 

Even  the  pineal  gland  has  imposed  itself  upon  the  psychic 
field,  a  teratoma  of  this  organ  having  caused,  in  a  5  year  old 
child  whose  case  was  reported  by  Frankl-Hochwart,  so  rapid 
a  mental  development  that  he  reasoned  as  would  a  young 
man  with  a  predilection  for  ethical  and  philosophical  ques- 
tions. Another  boy  of  4  years,  observed  by  Ostreich-Slavyk, 


BORDERLAND  DEFECTIVES  321 

also  showed  extraordinary  wisdom.  Indeed  so  remarkable 
are  the  evidences  of  psychic  development  when  this  little 
organ  is  hypertrophied  or  the  seat  of  a  tumor,  that  one  won- 
ders whether  the  great  Swiss  philosopher  and  physician, 
Haller,  who,  before  he  had  reached  his  tenth  year  had  writ- 
ten a  Chaldee  grammar,  a  Greek  and  Hebrew  vocabulary, 
and  a  large  collection  of  Latin  verses  and  biographies  — 
was  not,  after  all,  the  happy  possessor  of  a  tumor  of  the 
pineal  gland ! 

Dementia  praecox  is  a  disease  which  strikes  adolescents  of 
both  sexes.  These  young  subjects  are  committed  to  asylums 
in  this  country  alone  at  the  rate  of  about  20,000  a  year. 
Their  accumulation  is  such  in  the  institutions  for  the  insane 
of  forty-eight  states,  that  when  the  last  census  was  taken, 
about  120,000,  over  one-half  of  the  total  inmates,  were 
cases  of  dementia  praecox.  All  these  poor  beings  are  merely 
stored  at  present  —  buried  as  it  were  —  with  death  as  their 
only  redeemer. 

IS  THERE  MEDICAL  HELP  FOR  SOME  DEFECTIVES? 

Are  there  certain  classes  of  mental  defectives  which  are 
not  such  from  direct  inheritable  defects  in  the  germ-plasm? 
Are  some  forms  of  mental  deficiency  due  to  lack  of  internal 
secretions?  If  this  is  really  the  case  —  then  medical  science 
will,  sooner  or  later,,  find  a  remedy  for  this  group  —  even 
though  it  may  never  offer  help  to  those  who  are  disinherited 
because  of  defective  germ-plasm. 

Dr.  M.  W.  Barr,  of  Elwyn,  states  that  there  are  350,000 
avowed  mental  defectives  in  the  United  States,  and  that  328,- 
ooo  of  these  are  at  large  "  perpetuating  unrestrained  the  de- 
filement of  the  race."  The  Russell  Sage  Foundation  has 
shown,  moreover,  basing  its  estimate  on  a  study  of  the 
schools  of  thirty-one  American  cities,  that  over  one-fifth  of  all 
the  children  in  the  public  schools  of  the  United  States  belong 


322  RACE  DECADENCE 

to  the  retarded  class  —  to  say  nothing  of  those  who  do  not 
attend  school.  Again,  in  practically  every  phase  of  physical 
degeneracy,  from  one  cause  or  another,  we  are  forced  to  rec- 
ognize a  more  or  less  serious  increase.  So  marked,  indeed, 
in  some  directions  is  this  increment,  that  we  cannot  but  agree 
with  Dr.  Kehoe  when  he  states  that  the  time  is  not  far  off 
when  "  to  see  an  individual  of  natural  poise,  normal  mind, 
and  healthy  body,  will  be  the  exception  and  not  the  rule." 

Dr.  Sajous  thinks  that  at  least  some  of  these  subnormal 
sufferers  are  going  to  be  helped  sometime  in  the  near  future, 
when  we  better  understand  the  ductless  glands  of  the  body 
and  know  how  to  administer  these  substances  as  derived 
from  the  lower  animals.  He  says : 

How  could  this  evil  be  stemmed?  How  could  we,  physicians, 
while  supporting  the  praiseworthy  effort  of  the  eugenist  on  behalf 
of  the  child  of  the  future,  protect  the  child  of  today  and  the  unborn 
but  doomed  of  tomorrow,  for  whose  welfare  we  are,  more  than 
anyone  else  in  the  world,  responsible?  We  know  that  soon  after 
birth,  one  year,  two  years  at  most,  the  erstwhile  plastic  material  of 
which  the  organ  of  mind  is  composed,  will  have  been  molded  into 
its  permanent  shape,  that  of  the  feeble-minded;  we  know  also  that 
puberty  may  so  disturb  the  psychic  equipoise  as  to  transform  an 
erstwhile  bright  child  into  an  asylum  inmate.  How  could  we  relieve 
our  generation  of  fetters  so  harmful  to  its  development,  so  prolific 
in  suffering  for  innocent  victims  of  the  "  iniquity  of  the  fathers  " 
visited  "upon  the  children  unto  the  third  and  fourth  generation?" 
A  searching  study  of  the  subject  has  imposed  upon  me  the  con- 
clusion that  we  h£ve  the  means  for  the  salvation  of  a  large  propor- 
tion of  the  infants  of  our  day  from  feeble-mindedness  and  of  many 
children  doomed  to  precocious  insanity  through  an  adequate  con- 
ception of  the  meaning  of  the  ductless  glands  in  the  morbid  process. 

INTERNAL  SECRETIONS  AND  HEREDITY 

While  it  is  not  generally  accepted  in  the  scientific  world, 
it  is  nevertheless  interesting  to  examine  this  idea  of  internal 
secretions  in  relation  to  heredity.  Sajous  continues : 

There  is  thus  a  solid  foundation  for  my  belief  that  what  in 
reality  a  mentally  defective  child  inherits  from  his  parents  and  an- 


BORDERLAND  DEFECTIVES  323 

cestry  is,  (i)  a  tendency  to  defective  physiological  nutrition  and 
development  of  his  cerebral  neurons;  (2)  inability  to  break  down 
adequately  various  endogenous  toxics  capable  of  awakening  active 
psychical  disorders;  and  (3)  that  both  these  morbid  conditions  are 
traceable  back  to  the  degenerative  disorders  caused  in  the  ductless 
glands  of  parents  or  ancestors  by  the  diseases  and  intoxications 
known  to  lead  to  the  genesis  of  mentally  defective  offspring.  Briefly, 
the  main  underlying  cause  of  defective  mentality  in  both  parent  and 
offspring  is  inherited  deficient  activity  of  the  ductless  glands. 

Under  these  conditions,  a  pregnant  defective  fails  to  supply  her 
fetus  with  the  ductless  gland  secretions  it  requires.  If  the  father 
is  also  a  defective,  we  know  that  the  product  of  conception,  when 
developed,  will  prove  to  be  a  defective.  Why  permit  this?  Why 
seal  the  child's  fate  through  inactivity?  I  believe  that  with  what 
knowledge  we  have  of  the  ductless  glands  even  at  the  present  time, 
•we  should  start  a  campaign  having  in  view  the  salvation  of  these 
unfortunate  infants  by  supplying,  through  the  intermediary  of  their 
defective  mothers,  and,  after  birth,  through  their  food,  the  secre- 
tions they  lack  to  complete  their  development.  This  could  be 
accomplished  by  administering  organic  products  to  the  mother  dur- 
ing pregnancy  and  while  she  is  nursing  her  infant,  or  if,  as  is  the 
rulf,  the  latter  is  fed  artificially,  by  the  addition  of  the  organic 
products  to  the  cow's  or  goat's  milk  used.  On  what  ground  could  we 
hope  to  benefit  the  child  by  these  measures? 

The  fact  that  the  ductless  glands  play  an  important  role  during 
pregnancy  is  so  well  known  that  a  brief  summary  of  some  of  the 
evidence  is  all  that  will  be  submitted.  As  to  the  pituitary,  it  was 
found  to  be  overactive  during  pregnancy  by  Comte,  Launois,  and 
Mulon,  and  others.  Swale  Vincent  states  in  fact  that  it  may  en- 
large to  two  or  three  times  its  normal  size.  The  thyroid  is  so 
active  also  that  its  enlargement  is  often  noticeable  — 108  times  in 
133  cases  of  pregnancy  studied  by  Lang.  If  deficiency  of  the  thyroid 
is  present,  convulsions  occur,  but  these  may  be  arrested  by  ad- 
ministering thyroid  gland.  Disorders  of  the  pituitary  also  give  rise 
to  psychosis.  As  stated  by  Gushing,  referring  to  his  cases,  and 
quite  in  accord  with  my  own  observations,  "  One  form  or  another 
of  psychic  irregularities  have  manifested  themselves  in  the  larger 
number  of  patients."  Whether  we  grant  that  this  organ  produces 
a  secretion,  or  accept  my  own  view  that  it  coordinates  the  functions 
of  the  other  ductless  glands  through  the  sympathetic  system,  does 
not  modify  the  fact  that  it  also  controls  metabolism.  Here  again 
we  meet  psychasthenic  states  of  a  melancholic  type  sometimes  at- 
tended by  delusions  of  persecution,  convulsions,  etc.,  all  due  to 
defective  destruction  of  tissue  wastes. 

The  thymus  is  so  important  an  organ  in  this  connection  that  it 


324  RACE  DECADENCE 

may  be  said  to  stand,  in  respect  to  idiocy  and  dementia  praecox,  as 
the  thyroid  does  to  myxedema  and  cretinism.  It  is  the  gland  upon 
which,  from  my  viewpoint,  the  brain  cells  depend  for  their  develop- 
mental supply  of  phosphorus-laden  nucleins;  if  it  fails  through 
organic  disease,  defective  development,  or  premature  involution,  to 
furnish  its  product,  the  organ  of  mind  remains  undeveloped  and 
idiocy  results.  So  evident  is  this  connection  that  Bourneville  found 
the  thymus  absent  in  twenty-eight  idiotic  children  examined  post- 
mortem, while  the  organ  was  found  normal  in  sixty-one  children  of 
normal  mentality  who  died  of  various  diseases.  Clear  evidences  of 
idiocy  are  also  obtained  in  animals  deprived  early  of  the  thymus. 

"  FUNCTIONAL  DEFECTIVES  "    , 

In  other  words  Sajous  believes  that  many  of  our  mental 
and  nervous  defectives  are  "  functional  defectives  "  —  not 
organic  defectives ;  and  he  further  states  the  case  as  follows : 

The  thousands  of  purely  functional  defectives  which  the  country 
contains,  as  we  have  seen,  are  not,  judging  from  personal  cases,  the 
children  of  parents  in  whom,  in  most  instances,  clearly  defined  stig- 
mata can  be  discerned.  This  means  that  any  infant  may  become  a 
defective  unless  its  development  is  closely  watched  by  the  attending 
physician.  At  the  present  time  the  evil  trend  is  discovered  too  late 
to  save  the  child's  mind.  Were  every  infant  closely  watched  from 
birth,  and  its  development,  physical  and  mental,  compared  with  that 
of  a  normal  child  (standard  tables  being  available  in  most  works 
on  pediatrics),  timely  treatment  could  be  instituted  and  a  large 
proportion  of  them  redeemed.  In  addition  to  the  use  of  organic 
products  indicated  by  the  stigmata  discovered,  the  special  senses 
should  be  cultivated,  external  impressions  being  all-important  factors 
in  psychic  development.  It  should  be  remembered  also  that  dis- 
orders of  eyes,  ears,  nose,  and  nasopharynx  may  be  the  underlying 
cause  of  defective  mental  development  in  infants. 

By  the  phrase  "  purely  functional  defectives "  I  mean  infants  in 
whom  the  ductless  glands,  though  congenially  debilitated,  are  not 
the  seat  of  organic  lesions,  and  in  whom  also  the  cerebral  tissues, 
though  undeveloped,  are  susceptible  to  development  through  organo- 
therapy. Unfortunately,  as  is  well  known,  a  large  proportion  of 
idiots,  post-mortem  show  lesions  of  the  brain,  such  as  sclerosis, 
atrophy,  softening,  etc.,  which  no  longer  are  cultivable  soils.  Yet, 
distinct  improvement  is  often  obtainable,  even  in  such  cases.  This 
is  because  the  degenerated  areas  are  seldom  bilateral  and  the  corre- 
sponding areas  on  the  opposite  side  of  the  brain  can  thus  be  made, 


BORDERLAND  DEFECTIVES  325 

through  improved  nutrition  and  oxidation,  to  compensate,  to  a  re- 
markable extent  sometimes,  for  the  shortcomings  of  the  functionless 
areas.  Even  these  lesions  are  sometimes  subject  to  improvement, 
Cattani,  Klebs,  and  others  having  shown  that  regeneration  occurs 
occasionally  when  the  lesions  are  comparatively  slight  and  of  recent 
formation. 

With  this  theory  the  author  can  entertain  much  sympathy 
—  at  least  in  regard  to  many  forms  of  backwardness,  defi- 
ciency, and  even  some  forms  of  insanity,  including  the 
dreaded  dementia  praecox ;  but  when  it  conies  to  out-and-out 
feeble-mindedness,  I  do  not  look  for  much  help  from  such 
sources. 

OTHER  HEREDITARY  DISORDERS 

While  most  of  the  defects  and  diseases  about  to  be  enu- 
merated would  not  be  sufficient  ground  for  preventing  their 
victims  from  marriage,  and,  in  many  cases,  if  suitably  super- 
vised, would  not  endanger  offspring,  yet  on  the  whole  they 
represent  directly  inheritable  defects  which  should  render 
marriage  doubtful,  and  would  be  in  most  cases,  from  a  eu- 
genic standpoint,  a  centra-indication  to  reproduction.  Among 
the  disorders  which  are  definitely  inheritable  may  be  men- 
tioned: Friedreich's  ataxia,  Meniere's  disease,  speech  de- 
fects, eye  defects,  night  blindness,  color  blindness,  ear  de- 
fects, skin  diseases,  Thomsen's  disease,  hemophilia,  cretinism, 
and  polydactylism. 

Chorea  (St.  Vitus'  dance)  is  an  inheritable  nervous  dis- 
order, partly  physical,  but  more  largely  temperamental  and 
neurotic.  It  represents  one  of  the  inheritable  nervous  dis- 
eases and  is  an  additional  evidence  of  the  increasing  nervous 
instability  of  some  modern  races.  While  it  may  be  quite 
wholly  cured  by  proper  treatment  and  nervous  discipline,  and 
while  it  could  hardly  be  said  to  be  a  disorder  of  sufficient 
gravity  always  to  prevent  the  marriage  of  those  afflicted  by 
it,  nevertheless,  it  does  represent  a  nervous  racial  instability 


326  RACE  DECADENCE 

which  should  be  distinctly  recognized  as  a  thing  transmissible 
to  future  generations. 

Huntington's  chorea  is  another  peculiar  nervous  disease 
which  is  almost  unerringly  transmitted  to  succeeding  gener- 
ations. If  victims  of  this  disorder  are  allowed  to  marry  at 
will,  this  comparatively  new  disease  will  soon  be  more  or  less 
spread  over  the  entire  country.  It  is  a  definitely  inheritable 
disorder,  and  illustrates,  in  a  most  graphic  manner,  the  fact 
that  many  of  these  diseases  can  be  controlled,  or  their  spread 
prevented,  if  suitable  preventive  measures  are  employed. 

Stuttering  and  stammering  and  other  speech  defects,  while 
not  serious  from  the  standpoint  of  racial  decadence  are,  nev- 
ertheless, of  interest  as  being  indicative  of  the  widespread 
prevalence  of  nervous  instability  among  the  American  people ; 
and  it  is  enlightening  in  this  connection  to  know  that  the 
experts  who  deal  with  these  disorders  estimate  that  there  are 
between  four  and  five  hundred  thousand  actual  stammerers 
and  stutterers  in  the  United  States. 

This  country  is  also  cursed  with  an  increasing  number  of 
defective  and  subnormal  persons  who  belong  to  the  class  of 
so-called  "  feebly  inhibited "  individuals.  This  class  em- 
braces that  large  group  of  nomadic  and  irresponsible  men 
and  women  who  were  characterized  by  a  tendency  toward 
truancy  when  younger.  In  this  class  of  the  "  feebly  inhib- 
ited "  are  also  to  be  found  those  unfortunates  who  are  vic- 
tims of  violent  temper,  and  who  possess  such  a  small  degree 
of  self-control  as  to  be  a  source  of  constant  friction  as  they 
mingle  with  their  fellows.  In  a  still  further  subdivision  of 
this  group  may  be  found  various  types  of  "  peculiar  "  people, 
the  majority  of  whom  —  while  not  distinctly  dysgenic  — 
turn  out  to  be  social  and  economical  misfits. 

These  numerous  minor  nervous  disorders  are  all  just  as 
definitely  hereditary  as  the  more  grave  mental  diseases; 
but,  do  not  so  seriously  threaten  the  stability  of  the  race. 


BORDERLAND  DEFECTIVES  327 

SUMMARY  OF  THE  CHAPTER 

1.  There  are  numerous  "borderland"  defectives,  not  so 
grave  as  feeble-mindedness,  but  which  are  also  more  or  less 
hereditary. 

2.  "  Maternal  impressions  "  and  "  prenatal  influences  "  are 
not  accepted  as  an  explanation  for  inherited  defects  and  de- 
formities. 

3.  Science  does  not  credit  the  belief  that  you  can  frighten 
an  expectant  mother  and  thereby  mark  or  disfigure  the  unborn 
child. 

4.  Many  of  these  doubtful  defectives,  from  the  eugenic 
standpoint,  are  glad  to  remain  celibate  and  thus  give  the  next 
generation  the  benefit  of  the  doubt. 

5.  Among  the  physical  causes  associated  with  delinquency 
may  be  mentioned :  malnutrition,  disease  of  the  special  senses, 
bad  teeth,  sex  disorders,  headache,  etc. 

6.  So-called  stigmata  of  degeneracy  were  found  in  only 
13  per  cent  of  1,000  criminals  examined  by  Healy. 

*  7.  Dementia  praecox,  while  largely  hereditary,  does  also 
appear  (like  Mongolian  idiocy)  in  families  which  represent 
fairly  good  stock. 

8.  Some  authorities  think  that  dementia  praecox,  in  com- 
mon with  other  minor  mental  disorders,  is  due  to  disturbances 
in  the  internal  secretions. 

9.  Disorders  of  both  the  thymus  and  pineal  glands  are  as- 
sociated with  marked  and  profound  disturbances  of  the  mind 
and  nervous  system. 

10.  Precocious  prodigies  who  astonish  the  world  by  their 
early  mental  development  may  simply  be  the  victims  of  a 
tumor  of  the  pineal  gland. 

11.  Twenty  thousand  dementia  praecox  cases  are  sent  to 
asylums  in  this  country  every  year. 

12.  There  are  over  120,000  cases  of  dementia  praecox  in 
the  asylums  of  the  country  —  one-half  of  the  total  number  of 
inmates. 

13.  Of  350,000  avowed  mental  defectives  in  the  United 
States,  328,000  are  at  large  perpetuating,  without  restraint, 
their  defective  strains. 

14.  The  Russell  Sage  Foundation  finds  20  per  cent  of 


328  RACE  DECADENCE 

school  children  retarded  in  a  study  embracing  thirty-one 
cities. 

15.  It  would  seem  that  the  time  is  not  far  off  when  an  in- 
dividual of  natural  poise  and  normal  mind  will  be  the  excep- 
tion instead  of  the  rule. 

1 6.  Science  may  some  day  (through  ductless  gland  ther- 
apy) effect  the  cure  of  some  of  the  non-hereditary  forms  of 
both  insanity  and  other  sorts  of  mental  defectiveness. 

17.  Sajous  believes  that  many  of  these  minor  cases  of  de- 
fectiveness owe  their  origin  to  an  inherited  deficiency  of 
ductless  gland  activity. 

1 8.  The  pituitary  gland  and  the  thyroid  gland  are  both 
active  during  pregnancy  and  some  authorities  think  they  in- 
fluence the  fetal  development. 

19.  The  child  deficient  in  internal  secretions  is  supposed 
to  be  helped  by  feeding  the  missing  substance  to  the  mother 
both  before  and  after  the  birth  of  the  child. 

20.  This  group  of  disordered  minds  due  to  deficient  inter- 
nal gland  secretions  is  termed  "  functional  defectives." 

21.  These  methods  may  some  day  assist  in  curing  many 
forms  of  backwardness  and  even  the  dreaded  dementia  prae- 
cox  —  but  hardly  out-and-out  feeble-mindedness. 

22.  Other   inherited   disorders    are:    Friedreich's    ataxia, 
Meniere's  disease,  speech  defects,  eye  defects,  night  blindness, 
color  blindness,  Thomsen's  disease,  hemophilia,  cretinism,  etc. 

23.  St.  Vitus'  dance  (chorea),  Huntington's  chorea,  and 
stammering  are  also  inherited  disorders. 

24.  There  are  almost  half  a  million  actual  stammerers  in 
this  country. 


CHAPTER  XXIII 
THE  "ARISTOCRACY  OF  THE  UNFIT  " 

WE  ARE  supporting  ^an  idle  population  of  defectives 
amounting  to  more  than  i  per  cent  of  the  total  pop- 
ulation, at  an  expense  to  the  state  and  nation  of  more  than 
$100,000,000  a  year.  The  names  of  these  insane,  idiots, 
criminals,  and  paupers  are  registered  in  state  hospitals,  asy- 
lums, almshouses,  and  prisons,  together  with  something  of 
their  pedigrees.  And  with  this  evidence  of  unfitness  clearly 
before  us,  we  permit  many  of  these  defectives  to  breed  more 
a^d  worse  lunatics,  idiots,  criminals,  and  paupers. 

Rubner  in  an  address  before  an  international  congress  re- 
cently said  that,  "  the  human  is  deteriorating  and  that  a  given 
number  of  people,  five  or  ten  thousand,  would  be  found  to 
weigh  less  in  the  aggregate  at  the  present  time  than  the  same 
number  of  people  a  generation  ago." 

Sir  Ray  Lankaster  states : 

Civilized  mankind  appears  to  be  very  nearly  completely  in  a  con- 
dition of  "  cessation  of  selection. '  It  is  the  better-provided  and 
well-fed,  well-clothed,  protected  classes  of  the  community  in  which 
the  cessation  of  selection  is  most  complete.  Racial  degeneration  is, 
therefore,  to  be  looked  for  in  those  classes  quite  as  much  as  in  the 
half-starved,  ill-clad  struggling  poor,  if,  indeed,  it  should  be  ex- 
pected to  be  more  strongly  marked  in  them.  These  are  facts  which 
tend  to  show  that  such  anticipations  are  well  founded. 

THE  DECADENT  CLASSES 

Perhaps  it  will  be  as  well  to  take  a  bird's-eye  view  of  the 
whole  field  of  human  decadency.  Let  us  always  bear  in  mind 
that  it  is  the  defective  individual  that  is  dangerous  to  society, 

329 


33°  RACE  DECADENCE 

and  not  a  so-called  class  of  defectives.  We  are  not  justified 
in  cutting  off  the  future  line  of  some  member  of  society  just 
because  he  happens  to  belong  to  some  class  or  group  which 
may  for  the  time  being  be  under  social  stigmatism. 

On  the  other  hand  it  would  not  be  fair  to  future  genera- 
tions if  we  should  permit  a  manifestly  defective  individual 
to  reproduce  just  because,  in  some  manner  he  receives  the 
social  sanction  of  belonging  to  a  supposedly  immune  group  of 
society.  Bearing  in  mind  these  facts,  we  believe  that  ener- 
getic means  should  be  employed  to  prevent  the  future  repro- 
duction of  the  grossly  defective  —  such  as  the  feeble-minded, 
insane,  epileptic,  and  the  unmistakably  inherent  delinquents 
and  degenerates. 

INSTITUTIONAL   DEFECTIVES 

Stop  for  a  moment  and  consider  the  vast  host  of  the  "  aris- 
tocracy of  the  unfit,"  comfortably  housed  in  the  various 
classes  of  public  institutions  in  the  United  States.  In  round 
numbers  we  have  the  following: 

Blind  —  total,  100,000  approximately.  Of  these,  about 
50,000  are  totally  blind,  and  50,000  partly  blind.  The  affec- 
tion is  stated  to  have  been  congenital  in  4,730  cases.  Of  the 
blind  19  per  cent  were  found  to  have  blind  relatives ;  4.5  per 
cent  were  returned  as  the  offspring  of  cousin  marriages. 

Deaf  —  total,  about  100,000  including  deaf  and  dumb. 
More  than  50,000  of  them  were  deaf  from  childhood  (under 
20),  12,609  being  deaf  from  birth.  At  least  4.5  per  cent  of 
the  deaf  were  stated  to  be  offspring  of  cousin  marriages, 
and  32.1  per  cent  to  have  deaf  relatives.  "  The  significance 
of  this  cannot  be  determined  unless  it  is  known  how  many 
normal  persons  have  deaf  relatives  (or  blind  relatives,  in 
considering  the  preceding  paragraph),  but  it  points  to  the 
existence  of  families  that  are  characterized  by  deafness  (or 
blindness)." 


THE  "ARISTOCRACY  OF  THE  UNFIT"  331 

Insane. —  The  last  census  enumerated  only  the  insane  who 
were  in  public  institutions;  they  numbered  about  190,000. 
The  recent  census  of  the  National  Commission  on  Mental 
Hygiene  showed  234,055  insane  patients  in  all  institutions  — 
public  and  private.  The  number  outside  of  institutions  is  con- 
siderable but  cannot  be  accurately  estimated. 

The  institutional  population  is  not  a  permanent,  but  mainly 
a  transient  one,  the  number  of  persons  discharged  from  in- 
stitutions in  one  year  being  about  30,000.  From  this  one  can 
get  some  idea  of  the  amount  of  neurotic  weakness  in  the 
population  of  the  United  States  —  much  of  it  congenital  and 
heritable  in  character. 

Feeble-minded. —  The  latest  census  lists  only  those  in  in- 
stitutions, who  totaled  about  40,000.  The  census  experts 
believe  that  200,000  would  be  a  conservative  estimate  of  the 
total  number  of  feeble-minded  in  the  country,  and  many 
psychologists  believe  that  300,000  would  be  more  nearly  ac- 
curate. The  number  of  feeble-minded  who  are  receiving  in- 
stitutional care  is  almost  certainly  not  more  than  10  or  15 
per  cent  of  the  total,  and  many  of  these  (about  15,000)  are 
in  almshouses,  not  special  institutions. 

Paupers. —  There  are  almost  100,000  paupers  in  alms- 
houses,  and  88,313  were  admitted  during  one  year,  which  in- 
dicates that  the  almshouse  paupers  are  a  rapidly  shifting 
group.  "  This  population,  probably  of  several  hundred  thou- 
sand persons,  who  drift  into  and  out  of  almshouses,  can 
hardly  be  characterized  accurately,  but  in  large  part  it  must 
be  considered  at  least  inefficient  and  probably  of  mentally 
low  grade." 

Criminals. —  The  inmates  of  prisons,  penitentiaries,  re- 
formatories, and  similar  places  of  detention  numbereo1  more 
than  100,000,  and  this  does  not  include  25,000  juvenile  delin- 
quents. "  The  jail  population  is  nearly  all  transient ;  one  must 
be  very  cautious  in  inferring  that  conviction  for  an  offense 


332  RACE  DECADENCE 

against  the  law  indicates  lack  of  eugenic  value ;  but  it  is  worth 
noting  that  the  number  of  offenders  who  are  feeble-minded 
is  probably  not  less  than  one-fourth  or  one-third.  If  the 
number  of  inebriates  could  be  added,  it  would  greatly  increase 
the  total;  the  inebriacy,  or  chronic  alcoholism,  is  generally 
recognized  now  as  indicating  in  a'  majority  of  cases  either 
feeble-mindedness  or  some  other  defect  of  the  nervous  sys- 
tem." The  number  of  criminals  who  are  in  some  way  neu- 
rotically tainted  is  placed  by  some  psychologists  at  50  per 
cent  or  more  of  the  total  prison  population. 
Other  defectives. —  Says  Johnson : 

Add  to  these  a  number  of  epileptics  (over  10,000),  tramps,  prosti- 
tutes, beggars,  and  others  whom  the  census  enumerator  finds  it  diffi- 
cult to  catch,  and  the  total  number  of  possible  undesirable  parents 
becomes  very  large.  There  are  over  5,000  inebriates  and  drug 
addicts  receiving  care  in  institutions  at  public  expense  all  the  time. 
It  is  in  fact  much  larger  than  appears  in  these  figures,  because  ot 
the  fact  that  many  people  carry  defects  that  are  latent  and  only 
appear  in  the  offspring  of  a  marriage  representing  two  tainted 
strains.-  Thus  the  feeble-minded  child  usually,  if  not  always,  has 
feeble-mindedness  in  both  his  father's  and  mother's  ancestry,  and 
for  every  one  of  the  patent  feeble-minded  above  enumerated,  there 
may  be  several  dozen  latent  ones,  who  are  themselves  probably 
normal  in  every  way  and  yet  carry  the  dangerously  tainted  germ- 
plasm.  The  estimate  has  frequently  been  made  that  the  United 
States  would  be  much  better  off  eugenically  if  it  were  deprived  of 
the  future  racial  contributions  of  at  least  10  per  cent  of  its  citizens. 
While  literally  true,  this  estimate  is  too  high  for  the  group  which 
could  be  considered  for  attempts  to  directly  control  in  a  practical 
eugenics  program. 

It  thus  appears  that  we  are  all  the  while  caring  for  about 
2,000,000  people  in  our  various  public  and  private  hospitals, 
dispensaries,  "  homes,"  asylums,  and  other  institutions  of  cor- 
rection, charity,  and  "  uplift." 

Statistics  gathered  by  Davenport  and  his  pupils  showed 
that  mental  defectives  constitute  at  the  present  time,  not  less 
than  i  per  cent  of  the  total  population,  and  defectives  of  other 


THE  "ARISTOCRACY  OF  THE  UNFIT"  333 

sorts  have  multiplied  to  such  a  degree  that,  according  to 
Laughlin,  not  less  than  10  per  cent  of  the  present  population 
of  the  United  States  must  be  regarded  as  so  unfit  that  they 
ought  not  to  be  permitted  to  multiply  their  kind.  Of  2,500,- 
ooo  children  born  each  year,  not  less  than  300,000  die  before 
they  are  a  year  old,  and  of  those  that  die,  probably  not  less 
than  half  perish  simply  because  they  are  unfit  to  live. 

THE  BIOLOGIST'S  ATTITUDE 

Modern  civilized  races  are  proud  of  their  ability  to  control 
nature  in  various  ways ;  and  it  is  an  insult  to  our  intelligence 
to  intimate  that  we  cannot  control  human  reproduction  so  as 
to  deliver  society  from  the  burden  and  disgrace  of  having  to 
support  about  1,000,000  helpless  defectives  and  dangerous 
degenerates.  The  cost  of  maintaining  this  vast  "  aristocracy 
of  l^ie  unfit  "  is  somewhere  in  the  neighborhood  of  $500,- 
000,000  a  year;  it  directly  costs  $100,000,000  a  year  for  in- 
stitutional maintenance  alone. 

Suppose  a  new  disease  plague  should  descend  upon  us 
which  would  strike  down  3  or  4  per  cent  of  the  population, 
not  merely  rendering  them  inefficient,  but  actually  throwing 
the  whole  number  of  smitten  individuals  on  the  community 
for  their  entire  support  at  a  cost  of  over  $100,000,000  an- 
nually. "What  would  we  think?  What  would  we  do?  Just 
because  these  things,  in  a  measure,  have  always  been,  we  are 
accustomed  to  the  burden  and  pay  little  or  no  heed  to  its  final 
threat  of  our  very  stability  and  existence. 

One  biologist  sums  up  the  proposition  thus : 

Natural  selection,  in  the  early  days  of  man's  history,  would  have 
killed  off  many  of  these  people  early  in  life.  They  would  have 
been  unable  to  compete  with  their  physically  and  mentally  more 
vigorous  fellows  and  would  have  died  miserably  by  starvation  or 
violence.  Natural  selection's  use  of  the  death-rate  was  a  brutal 
one,  but  at  least  it  prevented  such  traits  as  these  people  show  from 
increasing  in  each  generation.  Eugenists  hope  to  arrive  at  the 


334  RACE  DECADENCE 

same  result,  and  not  by  the  death-rate  but  by  the  birth-rate.  If 
germinally  antisocial  persons  are  kept  humanely  segregated  during 
their  lifetime,  instead  of  being  turned  out  after  a  few  years  of 
institutional  life  and  allowed  t6  marry,  they  will  leave  no  descend- 
ants, and  the  number  of  congenital  defectives  in  the  community  will 
be  notably  diminished.  If  the  same  policy  is  followed  through  suc- 
ceeding generations,  the  number  of  defectives,  of  those  incapable 
of  taking  a  useful  part  in  society,  will  become  smaller  and  smaller. 

RACIAL  ISHMAELITES 

Nearly  always  the  preponderance  of  defective  strains  are 
a  result  of  consanguineous  matings,  and  for  the  sake  of  illus- 
trating the  danger  to  heredity  through  the  introduction  and 
reproduction  of  such  defective  strains  it  is  permissible  to  cite 
two  well-known  cases :  "  The  progeny  of  Belle  Jukes  is  a 
dreary  monotony  of  harlotry  and  licentiousness  to  the  fifth 
generation,"  which  cost  the  state  of  New  York  more  than 
$1,700,000  in  75  years;  and  the  Nam  family,  which  has  im- 
posed a  financial  burden  of  $1,500,000  during  the  same 
period,  "  not  directly  in  the  care,  but  indirectly,  in  the 
damage  they  have  done." 

Out  of  1,200  descendants  from  the  founder  of  the  "  Jukes  " 
through  75  years,  310  were  professional  paupers,  who  spent 
in  all  2,300  years  in  poorhouses,  50  were  prostitutes,  7  mur- 
derers, 60  habitual  thieves,  and  130  common  criminals.  The 
loss  of  potential  usefulness,  cost  of  prosecutions,  expense  of 
maintenance  of  jails,  etc.,  Dugdale  estimated  to  be  over 
$1,000  for  each  member  of  the  family.  All  these  unfortunate 
results  could  have  been  avoided  had  the  original  criminals  in 
this  family  been  segregated  or  else  sterilized. 

Among  other  cases  where  whole  colonies  of  defectives 
spring  from  a  single  ancestor  we  have  as  illustrations  the 
"  Ishmaelites "  of  Indiana,  whose  descendants  are  today 
intermarried  with  more  than  200  other  families  who  have 
begotten  murderers,  prostitutes,  and  a  large  number  of 
illegitimates.  In  Rhode  Island  there  exists  a  whole  colony 


THE  "ARISTOCRACY  OF  THE  UNFIT"  335 

of  deaf-mutes  —  the  result  of  consanguineous  matings  of 
defective  and  related  strains. 

This  "  Tribe  of  Ishmael,"  numbering  1,692  individuals  in 
six  generations,  has  produced  121  known  prostitutes  and  has 
bred  hundreds  of  petty  thieves,  vagrants,  and  murderers. 
The  history  of  the  tribe  is  a  swiftly  moving  picture  of  social 
degeneration  and  gross  parasitism,  extending  from  its  seven- 
teenth-century convict  ancestry  to  the  present-day  horde  of 
wandering  criminal  and  defective  descendants. 

In  Kentucky  there  is  the  Owen  family.  From  the  original 
four  children  have  sprung,  since  about  1850,  a  total  of  1,750 
individuals,  among  them  121  prostitutes,  with  a  long  criminal 
record  and  a  number  of  murders. 

Extreme  examples  such  as  the  above  are  necessary  to  drive 
these  incontrovertible  facts  into  the  public  consciousness  and 
to  illustrate  the  utter  recklessness  of  permitting  the  admission 
into*  this  country  of  feeble-minded,  epileptic,  insane,  and 
imbecile  immigrants  who,  together  with  their  progeny, 
eventually  reach  the  hospitals,  almshouses,  and  prisons  of  the 
state. 

During  the  years  from  1914-1918,  during  which  time  the 
federal  government  suspended  deportation  of  immigrants  to 
belligerent  countries,  4,000  excludable  aliens  were  allowed  to 
remain  in  this  country,  1,723  of  whom  were  insane,  and  195 
suffering  from  some  loathsome  disease. 

THE  DEFECTIVE  "  L."  FAMILY 

In  a  rural  part  of  Pennsylvania  lives  the  "  L."  family. 
Three  generations  studied  by  expert  field  investigators,  who 
found  that: 

....  all  show  the  same  drifting,  irresponsible  tendency.  No  one 
can  say  they  are  positively  bad  or  serious  disturbers  of  the  com- 
munities where  they  may  have  a  temporary  home.  Certain  members 
are  epileptic  and  defective  to  the  point  of  imbecility.  The  father 


336  RACE  DECADENCE 

of  this  family  drank  and  provided  little  for  their  support  The 
mother,  though  hard  working,  was  never  able  to  care  for  them  prop- 
erly. So  they  and  their  twelve  children  were  frequent  recipients 
of  public  relief,  a  habit  which  they  have  consistently  kept  up.  Ten 
of  the  children  grew  to  maturity,  and  all  but  one  married  and  had 
in  their  turn  large  families.  With  two  exceptions  these  have  lived 
in  the  territory  studied.  Nobody  knows  how  they  have  subsisted, 
even  with  the  generous  help  they  have  received.  They  drift  in  and 
out  of  the  various  settlements,  taking  care  to  keep  their  residence 
in  the  county  which  has  provided  most  liberally  for  their  support. 
In  some  villages  it  is 'said  that  they  have  been  in  and  out  half  a 
dozen  times  in  the  last  few  years.  First  one  family  comes  slipping 
back,  then  one  by  one  the  others  trail  in  as  long  as  there  are  cheap 
shelters  to  be  had.  Then  rents  fall  due,  neighbors  become  suspicious 
of  invaded  hen  roosts  and  potato  patches,  and  one  after  another  the 
families  take  their  departure,  only  to  reappear  after  a  year  or  two. 

The  seven  children  of  the  eldest  son  were  scattered  years  ago 
through  the  death  of  their  father.  They  were  taken  by  strangers, 
and  though  kept  in  school,  none  of  them  proved  capable  of  ad- 
vancement. Three  at  least  could  not  learn  to  read  or  handle  the 
smallest  quantities.  The  rest  do  this  with  difficulty.  All  but  two 
are  now  married  and  founding  the  fourth  generation  of  this  line. 
The  family  of  the  fourth  son  are  now  county  charges. 

Of  the  fourteen  children  of  school  age  in  this  and  the  remaining 
families,  all  are  greatly  retarded.  One  is  an  epileptic,  and  at 
16  years  old  cannot  read  or  write.  One  at  15  is  in  the  third  reader 
and  should  be  set  down  as  defective.  The  remainder  are  from  one 
to  four  years  retarded. 

There  is  nothing  striking  in  the  annals  of  this  family.  It  comes 
as  near  the  lowest  margin  of  human  existence  as  possible  and 
illustrates  how  marked  defect  may  sometimes  exist  without  serious 
results  in  the  infringement  of  law  and  custom.  Its  serious  menace, 
however,  lies  in  the  certain  marriage  into  stocks  which  are  no 
better,  and  the  production  of  large  families  which  continue  to  exist 
on  the  same  level  of  semi-dependency.  In  place  of  the  two  de- 
pendents of  a  generation  ago  we  now  find  in  the  third  generation 
thirty-two  descendents  who  bid  fair  to  continue  their  existence  on 
the  same  plane  —  certainly  an  enormous  multiplication  of  the  initial 
burden  of  expense. 

From  cases  of  this  sort,  which  represent  the  least  striking 
kind  of  bad  breeding,  the  student  may  pass  through  many 
types  up  to  the  great  tribes  of  Jukes,  Nams,  Kallikaks,  Zeros, 
Dacks,  Ishmaels,  Sixties,  Hickories,  Hill  Folk,  Piney  Folk, 


THE  "ARISTOCRACY  OF  THE  UNFIT"  337 

and  the  rest,  with  which  our  readers  are  familiar.  It  is 
abundantly  demonstrated  that  most  of  their  trouble  is  the 
outcome  of  bad  heredity. 

Those  who  see  in  improvement  of  the  environment  the  cure 
for  all  such  plague  spots  as  these  tribes  inhabit,  overlook  the 
fact  that  "  man  largely  creates  his  own  environment."  The 
story  of  the  tenement  dwellers  who  were  supplied  with  bath- 
tubs, but  refused  to  use  them  for  any  other  purpose  than  to 
store  coal,  but  further  illustrates  this  fact. 

THE  ZERO  FAMILY 

Probably  the  most  complete  family  history  of  this  kind 
ever  worked  out  is  that  of  the  Zero  family  —  a  Swiss  family 
—  whose  pedigree  has  been  recently  unraveled  in  a  splendid 
manner  by  Jorger.  In  the  seventeenth  century  this  family 
divided  into  three  lines ;  two  of  these  have  ever  since  remained 
valiled  and  highly  respected  families,  while  the  third  has 
descended  to  the  depths.  This  third  line  was  established  by 
a  man  who  was  the  result  of  two  generations  of  intermar- 
riage, the  second  tainted  with  insanity.  He  was  of  roving 
disposition,  and  in  the  Valla  Fontana  found  an  Italian  vagrant 
wife  of  vicious  character.  Their  son  inherited  fully  his 
parental  traits  and  himself  married  a  member  of  a  German 
vagabond  family  —  Marcus,  known  to  this  day  as  a  vagabond 
family.  This  marriage  sealed  the  fate  of  their  hundreds  of 
descendants.  This  pair  had  seven  children,  all  characterized 
by  vagabondage,  thievery,  drunkenness,  mental  and  physical 
defect,  and  immorality.  In  1905,  190  members  of  this  family 
were  known  to  be  living,  and  probably  many  living  are  un- 
known on  account  of  illegitimate  birth. 

In  1861  a  sympathetic  and  charitable  priest  attempted  to 
save  from  their  obvious  fate  many  of  these  "  Zero  "  children 
and  others  who  resided  in  and  near  his  village,  by  placing 
them  in  industrious  and  respectable  families  to  be  reared 


RACE  DECADENCE 

under  more  favorable  auspices.  The  attempt  failed  utterly, 
for  every  one  of  the  Zero  children  either  ran  away  or  was 
enticed  away  by  his  relatives. 

The  blame  for  such  an  atrocity  as  this  family,  or  the 
Jukes,  does  not  rest  with  these  persons  themselves.  It  must 
be  placed  squarely  upon  the  shoulders  and  consciences  of  the 
intelligent  members  of  society  who  have  permitted  these  pre- 
determined degenerates  to  be  brought  into  the  world,  and 
who  are  today  taking  no  broadly  sympathetic  view  of  their 
treatment  by  exercising  preventive  measures. 

As  an  interesting  example  we  have  another  family  described 
by  Poellmann.  This  was  established  by : 

.  .  .  .  two  daughters  of  a  woman  drunkard  who  in  five  or  six 
generations  produced  all  told  834  descendants.  The  history  of  709  of 
these  are  known.  Of  the  709,  107  were  of  illegitimate  birth;  64  were 
inmates  of  almshouses ;  162  were  professional  beggars ;  164  were 
prostitutes;  130  were  convicted  criminals;  60  were  habitual  thieves; 
7  were  murderers.  Not  one  had  even  a  common-school  education. 
Only  20  learned  a  trade,  and  10  of  these  learned  it  in  state  prisons. 
They  have  cost  the  state  over  $1,250,000,  and  the  cost  is  still  going 
on.  Who  pays  this  bill?  What  right  had  an  intelligent  and  humane 
society  to  allow  these  poor  unfortunates  to  be  born  into  the  kind 
of  lives  they  had  to  lead,  not  by  choice  but  by  the  disadvantage  of 
birth?  Darwin  wrote  long  ago:  ".  .  .  .  except  in  the  case  of 
man  himself,  hardly  anyone  is  so  ignorant  as  to  allow  his  worst 
animals  to  breed." 

THE  SITUATION  IN  ILLINOIS 

In  appealing  to  the  State  Legislature  of  Illinois  for  the 
enactment  of  suitable  laws  looking  towards  the  better  han- 
dling of  the  problem  of  delinquents  and  defectives,  Charles  H. 
Thorne,  Director  State  Department  of  Public  Welfare  said : 

The  feeble-minded  criminal  is  at  last  being  placed  in  the  lime- 
light, which  is  a  most  hopeful  sign  of  progress. 

It  is  time,  because  with  all  of  the  wild  and  terrifying  statements 
the  truth  has  not  been  half  told. 

The  cold  fact  is  that  the  problem  is  greater  than  are  the  facilities 
of  society  to  cope  with  it  by  present  methods. 


THE  "ARISTOCRACY  OF  THE  UNFIT"  339 

Feeble-mindedness  represents  a  structural  brain  defect  and  is  in- 
curable, unimprovable,  and  degenerative. 

The  idiots  and  imbeciles  can  be  recognized  at  sight  and  are  not 
a  menace  because  they  can  be  cared  for  only  in  institutions  and 
rapidly  move  at  an  early  age  into  their  custody. 

It  is  the  moron  without  judgment,  who  is  both  the  direct  and  the 
indirect  menace  to  society;  direct  because  from  them  are  recruited 
the  prostitutes,  mothers  of  illegitimate  children,  and  sex  perverts; 
indirect,  because  they  are  prolific  and  certain  breeders  of  their  own 
kind.  Once  in  the  blood  the  menace  is  continuous ;  for  even  the 
normal  child  of  a  feeble-minded  parent  may  become  the  parent  of 
feeble-minded  children,  or  the  condition  may  not  reappear  before 
the  grandchildren  or  great-grandchildren. 

The  following  gives  the  latest  estimates  of  the  extent  of 
feeble-mindedness  and  is  based  upon  the  report  of  Dr.  A. 
J.  Rosanoff  (made  in  1916  for  the  National  Committee  of 
Mental  Hygiene)  which  contains  probably  the  most  accurate 
figures  now  obtainable  on  mental  deficiency.  Dr.  Rosanoff 
made  an  accurate  census  of  the  entire  population,  above 
school  age,  of  the  county  of  Nassau  in  New  York  State. 
This  county  was  selected  as  being  typical  of  the  state  in 
regard  to  proportion  of  urban  and  rural  dwellers,  immigrants, 
stable  residents,  etc.  The  population  was  115,827.  The  defi- 
nite abnormality  per  100,000  was : 

Insanity  34*-O 

Feeble-mindedness  546-5 

Epilepsy    62.2 

Inebriates,  criminals,  prostitutes,  etc 424.8 

Total    1.374-5 

The  social  maladjustments  of  the  cases  of  abnormality  were 
grouped  as  follows : 

Retardation  in  school 145-9 

Truancy,  unruliness,  etc 17-5 

Sex  immorality Io°-2 

Criminal  tendencies 65.2 

Vagrancy    

Dependency  242-« 


34°  RACE  DECADENCE 

Inebriety   276.3 

Drug  habits  3.5 

Domestic  maladjustments  12.1 

Medical  cases   49.1 

Other  groups  (mainly  those  in  institutions)  ....  319.5 

No  maladjustments  140.7 


Total    1,374-5 

Treatment  considered  necessary: 

Institutional  care  816.7 

Other  treatment  '. 392.0 

None    165.8 


Total 1,374-5 

APPLIED   TO    ILLINOIS 

Applied  to  the  State  of  Illinois  this  would  mean  that  with 
a  population  of  6,193,626  (United  States  Census  Bureau 
estimate  for  1917)  there  are: 

Insane   21,120 

Feeble-minded    38,848 

Epileptic  3,852 

Inebriates,  criminals,  etc 26,310 


Total   85,130 

The  need  for  treatment  would  be : 

Institution  care    50,584 

Other  treatment 24,279 

None   10,267 


Total   85,130 

To  meet  these  conditions  the  state  possesses : 

Eight  hospitals  for  insane,  housing  18,000,  which  indicates 
that  we  are  almost  up  with  the  insane  problem. 

One  institution  for  epileptics,  which  soon  will  be  able  to 
care  for  all  who  need  care. 

One  home  for  dependent  children,  which  can  handle  only 
the  most  pressing  cases. 

One  reformatory  for  youths,  containing  a  large  number 


THE  "ARISTOCRACY  OF  THE  UNFIT"  341 

of  mental  defectives  who  eventually  must  be  discharged,  but 
who  should  be  kept  for  life. 

Two  prisons  for  men  and  one  for  women,  also  containing 
a  large  number  of  mental  defectives  who  should  be  kept  for 
life. 

Two  correctional  schools,  one  for  boys  and  one  for  girls, 
and  both,  especially  the  one  for  girls,  being  temporary  homes 
for  mental  defectives  who  must  be  discharged  at  21  years  of 
age  whether  they  should  be  or  not. 

One  institution  for  feeble-minded,  with  2,335  inhabitants. 

THOSE  THAT  ARE  NEEDED 

Authority  and  appropriations  are  being  asked  for  another 
institution  for  feeble-minded,  which,  if  obtained,  will  ease 
the  pressure  a  little,  although  it  is  obvious  that  four  or  five 
more  are  needed  and  eventually  must  be  provided. 

There  is  a  great  demand  for,  and  an  early  state  venture, 
should  be,  an  institution  for  the  segregation  of  what  are 
known  as  the  mentally  defective,  delinquent,  or  the  feeble- 
minded with  criminal  activities  of  a  violent,  destructive 
character. 

It  will  be  possible  to  determine  who  should  be  sent  to  such 
a  place  only  after  long  observation  and  careful,  conservative, 
well-balanced  study. 

The  present  commitment  law  is  sufficient,  as  any  person  of 
doubtful  mentality  may  be  subjected  to  the  proper  prelimi- 
nary study  and  if  mental  deficiency  is  established  commitment 
can  be  made. 

The  trouble  lies  not  in  the  law  but  in  the  lack  of  sufficient 
plants. 

SUMMARY  OF  THE  CHAPTER 

i.  We  are  supporting  an  idle  population  of  defectives 
equal  to  I  per  cent  of  the  total  population  at  an  annual  ex- 
pense of  more  than  $100,000,000. 


342  RACE  DECADENCE 

2.  These  defectives  are  mostly  registered  in  public  institu- 
tions, and  yet  we  permit  most  of  them  to  continue  to  repro- 
duce their  undesirable  kind. 

3.  Natural  selection  —  so  thinks  Lankaster  —  has  about 
ceased  to  operate  in  the  case  of  the  modern  civilized  races. 

4.  We  have  assembled  in  our  various  public  institutions  a 
vast  "  aristocracy  of  the  unfit,"  who  enjoy  life  at  the  expense 
of  the  industrious  taxpayers. 

5.  In  this  country  we  have  over  100,000  blind — 50,000 
totally  blind,  19  per  cent  have  blind  relatives  and  almost  5 
per  cent  result  from  cousin  marriages. 

6.  We  have  100,000  deaf  and  dumb.     Over  12,000  deaf 
from  birth.    Again  about  5  per  cent  are  offspring  of  cousin 
marriages ;  32.1  have  deaf  relatives. 

7.  There  are  probably  not  less  than  250,000  insane  in  this 
country ;  and  the  feeble-minded  are  approximately  the  same 
in  number. 

8.  There  are  almost  100,000  paupers  in  the  almshouses  of 
this  country;  88,000  were  admitted  in  one  year,  the  total 
number,  therefore,  probably  numbers  several  hundreds  of 
thousands. 

9.  There  are  over  100,000  criminals  in  our  various  penal 
institutions,  exclusive  of  over  25,000  juvenile  delinquents. 

10.  There  are  over  5,000  drug  victims  receiving  public 
care;  about  10,000  epileptic,  not  to  mention  a  vast  army 
of  tramps,  prostitutes,  and  beggars,  who  also  belong  to  this 
great  "  aristocracy  of  the  unfit." 

n.  The  greatest  menace  of  all  are  those  normal  appearing 
individuals  who  are  "  carriers  "  of  these  latent  strains  of  de- 
fectiveness  —  who  may  enter  into  good  lines  of  heredity  and 
thus  fatally  degenerate  our  otherwise  good  stock. 

12.  It  appears  that  we  are  constantly  caring   for  over 
2,000,000  of  these  "  unfit "  in  the  public  and  private  institu- 
tions of  this  country. 

13.  Laughlin  asserts  that  fully  10  per  cent  of  our  present 
population  is  unfit  to  reproduce  itself. 

14.  It  is  a  disgrace  to  modern  society  that  it  does  not  de- 
liver itself  from  this  burden  of  supporting  over  1,000,000 
helpless  defectives  and  dangerous  degenerates. 

15.  The  total  cost  of  maintaining  this  vast  army  of  the 


THE  "ARISTOCRACY  OF  THE  UNFIT"  343 

unfit  is  over  $500,000,000  a  year,  $100,000,000  for  institu- 
tional care  alone. 

1 6.  What  would  we  think  of  a  new  disease  which  would 
strike  down  and  cripple  for  life  3  or  4  per  cent  of  our 
population?    That  is  what  unrestricted  reproduction  of  de- 
fectives is  doing. 

17.  The  "  Jukes  "  cost  the  state  of  New  York  almost 
$2,000,000  in  75  years.    The  Nam  family  $1,500,000  during 
the  same  period. 

18.  Among  1,200  Jukes  descendants  there  were:  310  pau- 
pers, 50  prostitutes,  7  murderers,  68  thieves,  130  criminals. 

19.  The  "  Tribe  of  Ishmael  "  numbering  1,692  individuals, 
in  six  generations  produced  121  prostitutes,  and  numberless 
thieves,  vagrants,  and  murderers.  ' 

20.  A  study  of  the  "  L."  family  serves  to  show  that  shift- 
lessness  and  general  irresponsibility  are  largely  hereditary. 

21.  The  Zero  family  tends  to  show  that  well-meant  chari- 
table and  reformatory  work  will  not  annul  the  inexorable 
laws  of  human  heredity. 

22.  In  the  case  of  the  Poellmann  family,  709  descendants 
are  known,  of  which  107  are  illegitimate,  64  in  almshouses, 
162  professional   beggars,    164    prostitutes,    130  convicted 
criminals,  60  habitual  thieves,  7  murderers. 

23.  In  a  New  York  State  survey,  the  following  per  100,000 
of  population  were  discovered:  insanity  341.0;  feeble-mind- 
edness  546.5 ;  epilepsy  62.2 ;  inebriates,  criminals,  and  pros- 
titutes 424.8,  total  1,374-5- 

24.  Applied  to  Illinois  this  rate  would  mean:  insane  21,- 
120;  feeble-minded  38,848;  epileptic  3,852;  criminals,  pros- 
titutes, etc.,  26,310,  total  85,130. 


CHAPTER  XXIV 
DESIRABILITY  OF  RESTRICTING  THE  UNFIT 

THERE  are  just  two  ways  of  trying  to  improve  the 
human  race  from  the  standpoint  of  heredity.  One  is  to 
seek  to  increase  the  rate  of  marriage  and  reproduction,  of 
the  more  desirable  elements  of  society  —  considered  from  a 
eugenic  viewpoint ;  the  other  method  consists  in  all  possible 
and  practical  efforts  looking  towards  the  restriction  of  the 
marriage  and  reproduction  of  the  defective  and  degenerate 
classes. 

A  RESTRICTIVE  PROGRAM 

The  restrictive  eugenic  program  has  been  formulated  by 
one  biologist  thus : 

We  suggest  nothing  more  than  that  individuals  whose  offspring 
would  almost  certainly  be  subversive  of  the  general  welfare,  be 
prevented  from  having  any  offspring.  In  most  cases,  such  in- 
dividuals are,  or  should  be,  given  life-long  institutional  care  for 
their  own  benefit,  and  it  is  an  easy  matter,  by  segregation  of  the 
sexes,  to  prevent  reproduction.  In  few  cases  it  will  probably  be 
found  desirable  to  sterilize  the  individual  by  a  surgical  operation. 
Such  coercive  restriction  does,  in  some  cases,  sacrifice  what  may  be 
considered  personal  rights.  In  such  instances,  personal  rights  must 
give  way  before  the  immensely  greater  interests  of  the  race.  But 
there  is  a  much  larger  class  of  cases,  where  coercion  cannot  be 
approved,  and  yet  where  an  enlightened  conscience,  or  the  subtle 
force  of  public  opinion,  may  well  bring  about  some  measure  of 
restraint  on  reproduction.  This  class  includes  many  individuals  who 
are  not  in  any  direct  way  detrimental  to  society;  and  who  yet  have 
some  inherited  taint  or  defect  that  should  be  checked,  and  of  which 
they,  if  enlightened,  would  probably  be  the  first  to  desire  the 
elimination.  The  number  of  high-minded  persons  who  deliberately 
refrain  from  marriage,  or  parenthood,  in  the  interests  of  posterity, 
is  greater  than  anyone  imagines,  except  a  eugenist  brought  into 

344 


RESTRICTING  THE  UNFIT  345 

intimate  relations  with  people  who  take  an  intelligent  interest  in 
the  subject. 

Of  course  there  are  many  cases  on  the  borderline  —  cases 
difficult  to  decide.  Shall  a  given  individual  whose  family 
history  is  tainted  with  epilepsy  or  insanity  marry  or  not 
marry?  This  is  the  most  difficult  problem  of  applied 
eugenics.  It  is  also  a  purely  personal  one  —  one  which  the 
individual,  and  not  society,  must  settle.  We  cannot  accept 
the  sweeping  generalization  sometimes  made  that  "  strength 
should  marry  weakness  and  weakness  marry  strength."  No 
more  can  we  hold  fast  to  the  ideal,  which  we  believe  to  be 
Utopian,  that  "  strength  should  only  marry  strength."  There 
are  cases  where  such  glittering  generalities  are  futile ;  where 
the  race  and  the  individual  would  both  be  gainers  by  a  mar- 
riage which  produced  children  that  had  some  family  taint, 
but  only  latent  or  in  but  slight  degree. 

tThe  mating  of  strength  with  strength  is  certainly  the  ideal 
which  society,  as  well  as  every  individual,  should  have. 

But  human  heredity  is  so  mixed  that  this  ideal  is  not  always 
practicable;  and  if  any  two  persons  wish  to  abandon  it,  society  is 
hardly  justified  in  interfering,  unless  the  case  be  so  gross  as  those 
which  we  have  already  discussed.  Progress  in  this  direction  is  to 
be  expected  mainly  from  the  enlightened  action  of  the  individual. 
Much  more  progress  in  the  study  of  heredity  must  be  made  before 
advice  on  marriage  matings  can  be  given  in  any  except  fairly  obvious 
cases.  The  most  that  can  now  be  done  is  to  urge  that  a  full  knowl- 
edge of  the  family  history  of  an  intended  life  partner  be  sought, 
to  encourage  the  discreet  inquiries  and  subtle  guidance  of  parents, 
and  to  appeal  to  the  eugenic  conscience  of  a  young  man  or  woman. 
In  case  of  doubt  the  advice  of  a  competent  biologist  should  be  taken. 
There  is  a  real  danger  that  high-minded  people  may  allow  some 
minor  physical  defect  to  outweigh  a  greater  mental  excellence. — 
Poponoe  and  Johnson. 

CHANGING   ATTITUDES   TOWARD  THE   SUBNORMAL 

In  ancient  times,  the  feeble-minded  were  regarded  as  per- 
sons who  stood  outside  the  pale  of  humankind,  having 


.346  RACE  DECADENCE 

forfeited  all  human  rights  either  because  they  were  "  demons 
possessed,"  "  accursed  of  the  gods,"  or  because  they  were 
peculiar  (hence  "  idiots ")  solitary  persons  who  were  in- 
capable of  human  intercourse.  The  deliberate  neglect  or 
abandonment  of  idiots  to  their  fate  was  countenanced  by  the 
laws  of  Lycurgus,  and  was  openly  practiced  by  the  Spartans. 
Cicero  intimates  that  the  practice  also  flourished  among  the 
Romans. 

The  teaching  of  the  Christian  religion  has  gradually 
wrought  an  improvement  in  the  treatment  of  the  defective 
classes,  as  well  as  of  the  "  demented  "  classes.  St.  Paul's 
injunction  to  "comfort  the  feeble-minded"  (i  Thess.  5:14), 
probably  refers  to  the  mentally  weak.  Christ  set  a  good 
example  by  pitying  the  demoniac  and  idiotic  children  who 
were  brought  to  him. 

During  the  Middle  Ages  the  attitude  assumed  toward  the 
feeble-minded  was  ever  changing.  The  court  jesters  and 
buffoons  are  said  originally  to  have  been  imbeciles,  while 
imbeciles  furnished  a  good  deal  of  the  entertainment  in  the 
castles  of  the  rich. 

This  attitude  of  frivolity,  however,  soon  changed  to  one 
of  superstitious  reverence.  "  The  senseless,  silly  chatter  of 
the  imbecile  became  the  revelation  of  '  heavenly  infants/  or 
'  infants  of  the  good  God.' "  Imbeciles  were  thought  to  be 
under  the  special  protection  of  the  dieties  and  to  hold  com- 
munication with  the  unknown. 

But,  as  Wallin  states :  "  Persecution  usually  follows  in 
the  wake  of  superstition  and  fanaticism,  and  so  ancient  cruel- 
ties were  re-enacted  during  the  period  of  the  Renaissance  and 
the  Reformation.  Imbeciles  were  again  persecuted  and  re- 
viled." Luther  and  Calvin  openly  denounced  them  as  pos- 
sessed of  the  evil  spirit,  "  filled  with  Satan."  At  this  time 
the  first  organized  public  effort  upon  any  scale  to  provide 
for  the  physical  care  and  comfort  of  the  feeble-minded  in  a 


RESTRICTING  THE  UNFIT  347 

residential  institution  was  begun.  This  attempt  was  made 
in  France  in  the  middle  of  the  seventeenth  century  by  St. 
Vincent  de  Paul  and  his  Conf  rerie  de  Charite. 

Seguin  entered  upon  his  work  in  1837  when,  at  the  age 
of  twenty-five,  he  founded  a  private  school  in  Paris,  the  first 
successful  school  expressly  established  for  the  training  of 
idiots.  After  eighteen  months  of  labor  he  had  taught  a 
feeble-minded  child  to  "make  good  use  of  the  senses,  to 
compare,  remember,  speak,  write,  and  count."  The  success 
of  his  "  physiological  education  of  all  the  senses  "  attracted 
visitors  from  all  over  the  civilized  world,  and  won  for  him, 
in  1842,  the  directorship  of  the  enlarged  school  for  idiots  at 
the  Bicetre.  At  the  time  of  the  revolution  in  1848  Seguin 
emigrated  to  America,  where  he  was  instrumental  in  found- 
ing the  early  American  state  institutions.  He  served  for  a 
short  time  as  the  superintendent  of  the  Massachusetts  School 
fot"  Idiotic  and  Feeble-minded  Youth  in  South  Boston,  now 
located  at  Waverley,  assisted  in  the  organization  of  the  state 
institution  at  Syracuse,  New  York,  and  was  associated  in  the 
direction  of  the  Pennsylvania  Training  School  for  Idiotic  and 
Feeble-Minded  Children  in  Philadelphia  (now  located  at 
Elwyn).  On  January  i,  1880,  he  opened  a  private  school  in 
New  York  City  (now  located  in  Orange,  New  Jersey),  but 
came  to  his  death  the  following  October. 

Seguin  sincerely  believed  that  his  methods  would  revolu- 
tionize the  training  of  normal  children  and  were  destined  to 
become  the  "  basis  of  the  education  of  mankind."  Certain  it 
is  that  his  work  became  the  model  and  inspiration  of  the 
subsequent  educational  work  and  social  care  of  the  feeble- 
minded, both  in  and  out  of  publicly  supported  institutions. 
"  It  gave  the  real  impetus  toward  the  organization  of  separate 
public  training  institutions  for  the  feeble-minded,  which  later 
led  to  the  founding  of  custodial  and  farm-colonies  for  the 
feeble-minded  and  the  epileptic." 


348  RACE  DECADENCE 

RESTRICTION  SUMMARIZED 

The  program  for  the  prevention  of  propagation  of  defeo 
tives  and  degenerates  may  be  stated  and  summarized  under 
four  heads: 

/.  Education. —  Efforts  to  enlighten  the  defectives  are 
foredoomed  to  failure,  but  the  education  of  the  more  intelli- 
gent classes  may  help  solve  these  eugenic  problems  by 
teaching  the  public  the  fact  that  so  much  of  human  misery 
and  misfortune  is  largely  preventable  and  may  be  controlled 
by  proper  social  regulation. 

2.  Restrictive  legislation. —  Restrictive  legislation  is  well 
intended,  but  has  signally  failed  as  a  preventive  measure,  for 
the  evident  reason  that  it  only  adds  illegitimacy  to  degen- 
eracy, and  thus  the  children  enter  on  life's  battle  doubly 
handicapped.     Minnesota  has  a  law  providing  that  within 
the  bounds  of  the  state  no  marriage  shall  be  permitted,  either 
party  to  which  is  epileptic,  imbecile,  feeble-minded,  or  in- 
flicted with  insanity,  unless  the  woman  be  over  45  years  old. 
Michigan,  Delaware,  Connecticut,  Indiana,  New  Jersey,  and 
North  Dakota  have  also  passed  laws  for  the  purpose  of  pre- 
venting marriage  among  defectives. 

3.  Segregation. —  Segregation  would  be  an  ideal  and  hu- 
mane method  of   eliminating  those  who  are  incapable  of 
having  normal  offspring.    The  segregation  of  all  degenerates 
and  defectives  would  be  an  enormous  and  impractical  task. 
Further,  the  great  difficulty  is  to  detect  the  unfit  individual 
who  starts  a  strain  of  defectives  and  degenerates.    "  It  is  evi- 
dently a  hopeless  task  to  know  where  to  draw  the  line  between 
the  fit  and  the  unfit,  so  that  for  the  present  we  must  be 
satisfied   to  enforce   restrictive  measures  upon  only  those 
who  are  evident  and  well-marked  examples." 

Insane  asylums,  homes  for  epileptics,  reformatory  schools, 
as  well  as  special  hospitals  and  institutions  for  advanced 


RESTRICTING  THE  UNFIT  349 

cases  must  not  be  regarded  as  preventive  measures  in  the 
true  sense,  for  such  segregation  provides  care  and  comfort 
as  a  terminal  measure;  that  is,  it  is  usually  a  last  resort. 
Frequently  defectives  propagate  their  kind  before  and  some- 
times after  they  are  segregated. 

4.  Surgery. —  Surgery  has  been  proposed  as  a  means  of 
controlling  the  propagation  of  defectives.  This  is  done  either 
by  severing  the  vas  deferens  or  the  Fallopian  tube.  At  the 
Indiana  Reformatory  the  law1  of  that  state  is  carried  out 
providing  for  the  sterilization  of  defectives.  The  operation 
of  vasectomy  consists  of  ligation  and  resection  of  a  small 
portion  of  the  vas  deferens.  The  operation  is  very  simple 
and  easy  to  perform.  It  may  be  done  with  a  local  anesthetic 
in  about  three  minutes,  and  the  subject  returns  to  his  work 
immediately,  suffering  no  inconvenience  and  in  no  way  ham- 
pered in  his  pursuit  of  life,  liberty,  and  happiness,  but  is 
effectively  sterilized.  In  456  cases  Dr.  Sharp  reports  no 
unfavorable  symptoms.2 

1  The  Indiana  sterilization  law  reads  as  follows : 

Whereas,  Heredity  plays  a  most  important  part  in  the  trans- 
mission of  crime,  idiocy,  and  imbecility; 

Therefore,  Be  it  enacted  by  the  General  Assembly  of  the  State 
of  Indiana,  that  on  and  after  the  passage  of  this  act  it  shall  be 
compulsory  for  each  and  every  institution  in  the  state,  entrusted 
with  the  care  of  confirmed  criminals,  idiots,  rapists,  and  imbeciles, 
to  appoint  upon  its  staff,  in  addition  to  regular  institutional  physi- 
cian, two  (2)  skilled  surgeons  of  recognized  ability,  whose  duty  it 
shall  be  in  conjunction  with  the  chief  physician  of  the  institution, 
to  examine  the  mental  and  physical  condition  of  such  inmates  as 
are  recommended  by  the  institutional  physician  and  board  of  man- 
agers. If,  in  the  judgment  of  this  committee  of  experts  and  the 
board  of  managers,  procreation  is  inadvisable  and  there  is  no  prob- 
ability of  improvement  of  the  mental  and  physical  condition  of  the 
inmate,  it  shall  be  lawful  for  the  surgeons  to  perform  such  opera- 
tion for  the  prevention  of  procreation  as  shall  be  decided  safest  and 
most  effective.  But  this  operation  shall  not  be  performed  except  in 
cases  that  have  been  pronounced  unimprovable. 

2  Since  this  was  written  the  State  Supreme  Court  has  declared 
the  sterilization  law  unconstitutional.     The  principal  point  taken  is 
that  the  statutes  do  not  give  the  person  concerned  a  hearing  before 


350  RACE  DECADENCE 

The  operation  on  the  female  is  somewhat  more  difficult,  but 
if  carefully  done  no  more  hazardous.  The  Fallopian  tubes 
are  reached  through  a  median  incision  and  ligated  near  the 
uterus  and  severed  beyond  the  ligature. 

Opinions  vary  greatly  concerning  the  propriety  of  steriliz- 
ing criminals,  insane,  degenerates,  and  defectives  generally. 
There  is  no  doubt  concerning  its  effectiveness.  Even  in  per- 
fectly clear  cases,  such  as  the  insane,  the  epileptic,  or  the 
high-grade  degenerate,  the  harm  has  often  been  done  before 
the  operation  has  been  decided  upon.  The  author  is  not 
blind  to  the  possibilities  for  abuse  in  the  procedure  of  sterili- 
zation, but  nevertheless  thinks  that  at  some  future  time  the 
opportunities  for  personal  injustice  may  be  so  minimized  that 
the  operation  will  come  into  general  use  in  the  management 
of  certain  classes  of  clear-cut  and  undoubted  racial  degen- 
eracy and  hopeless  defectiveness. 

These  four  methods  do  not  take  into  consideration  the 
ancient  practices  of  execution  and  castration ;  for  both  prac- 
tices are  not  to  be  considered  in  connection  with  any  twen- 
tieth-century program  for  race  improvement. 

We  are  not  unmindful  of  a  certain  objection  to  steriliza- 
tion, viz.  that,  "  It  is  likely  to  lead  to  the  spread  of  sexual 
immorality  and  venereal  disease."  This  objection  is  entitled 
to  some  consideration;  and  there  exists  still  another  objec- 
tion against  sterilization  as  a  program.  Most  of  the  persons 
whom  it  is  proposed  to  sterilize  are  utterly  unfit  to  hold  their 
own  in  the  world,  in  competition  with  normal  people.  For 
society  to  sterilize  the  feeble-minded,  the  insane,  the  alco- 
holic, the  born  criminals,  the  epileptic,  and  then  turn  them 
out  to  shift  for  themselves,  saying,  "  We  have  no  further 
concern  with  you,  now  that  we  know  you  will  leave  no 


a  judicial  body  where  he  may  present  his  side  of  the  case  and  evi- 
dence. The  question  was  also  raised  as  to  sterilization  being  an 
extra  punishment  not  ordered  by  a  court. 


RESTRICTING  THE  UNFIT  351 

children  behind  you,"  might  be  unwise.  People  of  this  sort 
should  be  humanely  isolated,  so  that  they  will  be  brought 
into  competition  only  with  their  own  kind ;  and  they  should 
be  kept  so  segregated,  not  only  until  they  have  passed  the 
reproductive  age,  but  until  death  brings  them  relief  from 
their  misfortunes. 

THE  PERSONAL  LIBERTY  DOCTRINE 

It  is  constantly  urged  that  the  state  should  not  interfere 
with  an  individual  matter  of  this  sort !  "  It  is  an  intolerable 
invasion  of  personal  liberty;  it  is  reducing  humanity  to  the 
level  of  the  barnyard;  it  is  impossible  to  put  artificial  re- 
straints on  the  relations  between  the  sexes,  founded  as  they 
are  on  such  strong  and  primal  feelings." 

The  doctrine  of  personal  liberty,  in  this  extreme  form, 
was  enunciated  and  is  maintained  by  people  who  are  igno- 
rant of  the  laws  of  heredity.1  Nature  reveals  no  such  ex- 
treme "  law  of  personal  liberty,"  and  the  race  that  tries  to 
carry  such  a  supposed  law  to  its  logical  conclusion  will  soon 
find,  in  the  supreme  test  of  competition  with  other  races,  that 
the  interests  of  the  individual  are  much  less  important  to 
nature  than  the  interests  of  the  race.  "  Perpetuation  of  the 
race  is  the  first  end  to  be  sought.  So  far  as  according  a 
wide  measure  of  personal  liberty  to  its  members  will  com- 
pass that  end,  the  personal  liberty  doctrine  is  a  good  one; 
but  if  it  is  held  as  a  metaphysical  dogma,  to  deny  that  the 
race  may  take  any  action  necessary  in  its  interest,  at  the 
expense  of  the  individual,  this  dogma  soon  becomes  suicidal." 

As  for  "  reducing  humanity  to  the  level  of  the  barnyard," 


1  This  applies  even  to  such  an  acute  thinker  as  John  Stuart  Mill, 
whose  ideas  were  formed  in  the  pre-Darwinian  epoch,  and  whose 
works  must  now  be  accepted  with  great  reserve.  Darwin  was  quite 
right  in  saying,  "The  ignoring  of  all  transmitted  mental  qualities 
will,  as  it  seems  to  me,  be  hereafter  judged  as  a  most  serious  blemish 
in  the  works  of  Mr.  Mill."  Descent  of  Man,  p.  98. 


352  RACE  DECADENCE 

this  is  merely  a  catch-phrase  intended  to  arouse  prejudice  and 
to  obscure  the  facts.  The  reader  may  judge  for  himself 
whether  the  eugenic  program  will  degrade  mankind  to  the 
level  of  the  brutes,  or  whether  it  will  ennoble  it,  beautify  it, 
and  increase  its  happiness.  The  delusion  which  so  many 
people  hold,  that  it  is  impossible  to  put  artificial  restraint  on 
the  relation  between  the  sexes,  is  amazing.  "  Every  civilized 
nation  already  puts  restrictions  on  numerous  classes  of 
people,  as  has  been  noted  —  minors,  criminals,  and  the  insane, 
for  example.  Even  though  this  restriction  is  usually  based 
on  legal,  rather  than  biological  grounds,  it  is  nevertheless 
a  restriction,  and  sets  a  precedent  for  further  restrictions,  if 
any  precedent  were  needed." 

A  quotation  from  the  Principles  of  Political  Economy  1 
will  give  an  idea  of  Mr.  Mill's  point  of  view :  "  Of  all  the 
vulgar  methods  of  escaping  from  the  effects  of  social  and 
moral  influences  on  the  mind,  the  most  vulgar  is  that  of 
attributing  diversities  of  conduct  and  character  to  inherent 
natural  differences." 

It  is,  we  conclude,  both  desirable  and  possible  to  enforce 
certain  restrictions  on  marriage  and  parenthood.  What 
these  restrictions  may  be,  and  to  whom  they  should  be  ap- 
plied, is  the  real  problem  which  confronts  us. 

RESTRICTIVE  MARRIAGE 

In  all  matters  of  property  rights,  public-health  questions, 
and  in  numerous  other  channels  of  human  activities,  society 
asserts  and  enforces  its  superiority  over  the  individual;  but 
when  it  comes  to  the  perpetuation  of  the  race,  the  individual 
still  reigns  supreme.  Civilized  society  cannot  return  to  the 
law  of  the  jungle  where  race  is  determined  by  natural  selec- 
tion, so  we  must  seek  out  some  sort  of  compromise  which 
will  be  acceptable  to  the  ideals  of  our  civilization  and  at 

i  Vol.  I,  p.  389. 


RESTRICTING  THE  UNFIT  353 

the  same  time  afford  some  sort  of  protection  to  the  future 
of  the  race.  In  our  present  state  of  enlightenment  and  pub- 
lic opinion,  perhaps  the  first  step  in  restrictive  eugenics  had 
best  concern  itself  with  marriage  restriction  —  the  improve- 
ment in  our  marriage  laws.  Says  one  authority: 

There  are  millions  of  men  in  civilized  countries  whose  mental 
equipment  places  them  on  a  plane  with  barbarians  or  savages,  and 
they  have  on  the  average  more  offspring  than  their  civilized  con- 
temporaries. There  are  millions  of  others  who  are  so  seriously 
defective  in  body  or  mind,  owing  to  hereditary  causes,  that  they 
can  never  take  care  of  themselves  and  must  always  be  a  charge 
upon  the  state,  and  yet  in  many  civilized  countries  they  are  permitted 
to  perpetuate  their  kind  and  produce  a  never-ending  supply  of 
mental  and  moral  defectives,  whose  maintenance  must  seriously  inter- 
fere with  the  proper  education  and  development  of  the  normal 
population  and  whose  unrestrained  existence  constantly  threatens 
to  pollute  purer  streams  of  heredity.  The  practice  of  society  re- 
garding marriage  and  reproduction  up  to  the  present  has  been  to 
allow  all  sorts,  good,  bad,  and  indifferent,  to  propagate  with  the 
belief  that  good  environment  and  training  will  make  up  for  de- 
ficiencies of  birth. 

But  recently  the  conviction  has  been  growing  that  good 
environment  is  far  less  important  than  good  heredity  and 
that  in  some  way  society  must  influence  the  race  of  men  at 
its  source. 

One  author  thinks  dysgenic  traits  should  constitute  suffi- 
cient grounds  for  divorce.  He  says : 

We  consider  it  a  crime  for  people  to  marry,  without  knowing 
each  other's  family  histories.  But  in  spite  of  all  this,  ill-assorted, 
dysgenic  marriages  will  still  be  made.  When  such  a  marriage  is 
later  demonstrated  to  have  been  a  mistake,  not  only  from  an  in- 
dividual, but  also  from  a  eugenic  point  of  view,  society  should  be 
ready  to  dissolve  the  union.  Divorce  is  far  preferable  to  mere 
separation,  since  the  unoffending  party  should  not  be  denied  the 
privilege  of  remarriage,  as  the  race  in  most  cases  needs  his  or  her 
contribution  to  the  next  generation.  In  extreme  cases  it  would  be 
proper  for  society  to  take  adequate  steps  to  insure  that  the  dysgenic 
party  could  neither  remarry  nor  have  offspring  outside  of  marriage. 
The  time-honored  justifiable  grounds  for  divorce  —  adultery,  ster- 


354  RACE  DECADENCE 

ility,  impotence,  venereal  infection,  desertion,  non-support,  habitual 
cruelty,  appear  to  us  to  be  no  more  worthy  of  legal  recognition 
than  the  more  purely  dysgenic  grounds  of  chronic  inebriety,  feeble- 
mindedness, epilepsy,  insanity,  or  any  other  serious  inheritable 
physical,  mental,  or  moral  defect. 

This  view  of  the  eugenic  value  of  divorce  should  not  be 
construed  as  a  plea  for  admission  of  mutual  consent  as  a 
ground  for  divorce.  It  is  desirable,  however,  to  realize 
that  mismating  is  the  real  evil.  Divorce  in  such  cases  is 
merely  a  cure  for  an  improper  condition.  "  Social  condem- 
nation should  stigmatize  the  wrong  of  mismating,  not  the 
undoing  of  such  a  wrong." 

Restrictions  on  age  at  marriage  are  almost  universal.  The 
object  is  to  prevent  too  early  marriages.  The  objections 
which  are  commonly  urged  against  early  marriages  (in  so 
far  as  they  bear  upon  eugenics)  have  been  stated  as  fol- 
lows: 

1.  That  it  results  in  inferior  offspring.    This  objection  is 
not  well   supported  except  possibly  in  the  most  extreme 
cases.    Physically,  there  is  evidence  that  the  younger  parents 
on  the  whole  bear  the  sounder  children. 

2.  That  a  postponement  of  marriage  provides  the  oppor- 
tunity for  better  sexual  selection.     This  is  a  valid  ground 
for  discouraging  the  marriages  of  minors. 

3.  The  better-educated  classes  are  obliged  to  marry  late, 
because  a  man  usually  cannot  marry  until  he  has  finished 
his  education  and  established  himself  in  business.     A  fair 
amount  of  restriction  as  to  age  at  marriage  will  therefore 
not   affect   these  classes,   but   may   affect   the   uneducated 
classes.     In  so  far  as  lack  of  education  is  correlated  with 
eugenic  inferiority,  some  restriction  of  this  sort  is  desirable 
because  it  will  keep  inferiors  from  reproducing  too  rapidly, 
as  compared  with  the  superior  element  of  the  population. 

While  the  widespread  rule  that  men  should  not  marry 
under  21  years  and  women  under  18  years  has  some  justifi- 


RESTRICTING  THE  UNFIT  355 

cation,  then,  an  ideal  law  would  permit  exceptions  where 
there  was  adequate  income  and  good  mating. 

WHY   PERPETUALLY    SUPPORT   DEFECTIVES? 

Many  persons  do  not  seem  to  be  able  to  comprehend  a 
problem  until  it  is  put  upon  a  dollars  and  cents  basis.  For 
all  such  let  us  summarize  the  economic  side  of  racial  degen- 
eracy thus:  Why  should  the  able  and  worthy  and  thrifty 
members  of  society  continue  to  be  compelled  to  pay,  as  they 
are  in  this  country  alone,  $150,000,000  annually,  not  to  men- 
tion the  vast  sums  voluntarily  contributed  toward  "chari- 
table "  purposes,  for  the  support  of  the  criminal  and  pauper 
and  defective  classes  who  themselves  contribute  nothing  of 
value  and  whose  very  existence  is  evidence  of  criminal  dis- 
regard of  the  right  of  every  individual  to  be  well  born, 
into  a  healthy  and  sane  life?  The  only  answer,  if  it  be  an 
answer,  is  —  because  the  competent  are  willing  to  foot  the 
bill.  We  uncomplainingly  pay  millions  for  tribute  but  not 
one  cent  for  defense.  And  yet  a  penny's  worth  of  defense 
outweighs  a  million's  worth  of  cure. 

One  who  does  not  believe  that  these  people  hand  on  their 
traits  to  their  descendants  may  profitably  consider  the 
famous  history  of  the  so-called  Jukes  family,  a  strain  orig- 
inating among  the  "  finger  lakes"  of  New  York,  whose  his- 
tory was  published  by  R.  L.  Dugdale  as  far  back  as  1877 
and  lately  restudied  by  A.  H.  Estabrook.1 

From  one  lazy  vagabond  nicknamed  "  Jukes  "  born  in  1720,  whose 
two  sons  married  five  degenerate  sisters,  six  generations  numbering 
about  1,200  persons  of  every  grade  of  idleness,  viciousness,  lewdness, 
pauperism,  disease,  idiocy,  insanity,  and  criminality  were  traced.  Of 
the  total  seven  generations,  300  died  in  infancy;  310  were  profes- 
sional paupers,  kept  in  almshouses  a  total  of  2,300  years ;  440  were 
physically  wretched  by  their  own  "  diseased  wickedness ; "  more 
than  half  the  women  fell  into  prostitution,  130  were  convicted 

1  The  Jukes  in  1915,  Carnegie  Institution,  Washington,  1916. 


356  RACE  DECADENCE 

criminals;  60  were  thieves;  7  were  murderers,  only  20  learned  a 
trade,  10  of  these  in  state  prisons,  and  all  at  a  state  cost  of  over 
$1,250,000. 

The  clan  has  now  reached  its  ninth  generation  and  num- 
bers 2,820  individuals,  of  whom  half  are  still  living.  In 
the  early  eighties  they  left  their  original  home  and  are  now 
scattered  all  over  the  country.  The  change  in  environment 
has  enabled  some  of  them  to  rise  to  a  higher  level,  but  on 
the  whole,  says  C.  B.  Davenport  in  a  preface  to  Estabrook's 
book,  they  "  still  show  the  same  feeble-mindedness,  indo- 
lence, licentiousness,  and  dishonesty,  even  when  not  handi- 
capped by  the  associations  of  their  bad  family  name  and 
despite  the  fact  of  being  surrounded  by  better  social  con- 
ditions." 

How  heredity  works  both  ways,  is  shown  by  the  history 
of  the  Kallikak  family,  published  by  H.  H.  Goddard  a  few 
years  ago. 

At  the  beginning  of  the  Revolutionary  War  a  young  man,  known 
in  the  history  as  Martin  Kallikak,  had  a  son  by  a  nameless,  feeble- 
minded girl,  from  whom  there  have  descended  in  the  direct  line 
480  individuals.  Of  these  143  are  known  to  have  been  feeble-minded, 
and  only  46  have  been  known  to  be  normal.  The  rest  are  unknown 
or  doubtful.  Thirty-six  have  been  illegitimate ;  33,  sexually  immoral, 
mostly  prostitutes;  24  alcoholic;  3  epileptic;  82  died  in  infancy; 
3  were  criminal,  and  8  kept  houses  of  ill-fame.  After  the  war, 
Martin  Kallikak  married  a  woman  of  good  stock.  From  this  union 
have  come  in  direct  line  496,  among  whom  only  2  were  alcoholic, 
and  I  known  to  be  sexually  immoral.  The  legitimate  children  of 
Martin  have  been  doctors,  lawyers,  judges,  educators,  traders, 
landholders,  in  short,  respectable  citizens,  -men  and  women  prom- 
inent in  every  phase  of  social  life.  These  two  families  have  lived 
on  the  same  soil,  in  the  same  atmosphere,  and  in  short,  under  the 
same  general  environment,  yet  the  bar  sinister  has  marked  every 
generation  of  one  and  has  been  unknown  in  the  other. 

SCRUTINIZE    THE    IMMIGRANT 

The  inevitable  introduction  of  severe  functional  nervous 
disturbances,  insanity,  feeble-mindedness,  as  well  as  an  ex- 


RESTRICTING  THE  UNFIT  357 

cessive  amount  of  venereal  disease  through  immigration  is  a 
threat  always  hanging  over  this  nation's  head.  There  are 
now  in  this  after-war  period,  millions  of  widows  and 
orphans,  many  of  whom  are  seeking  a  domicile  in  this 
country  to  join  relatives  and  friends.  After  years  of  agoniz- 
ing distress  and  undernourishment  many  of  these  persons, 
particularly  the  children,  are  physically  and  mentally  sub- 
normal. We  cannot  hope  that  the  renewed  immigration 
will  bring  in,  even  among  those  who  cannot  be  excluded, 
the  hardy  stock  of  bygone  years.  (See  Fig.  18.)  We  are 
facing  a  definite  weakening  of  the  very  fiber  upon  which 
our  stability  as  a  nation  is  founded.  Bitter  are  the  casualties 
of  war,  but  of  a  bitterness  far  more  intense  are  the  casual- 
ties of  peace  —  our  failure  to  protect  the  social  integrity  of 
the  nation. 

Some  economic  evils  we  may  not  be  able  to  prevent,  but 
thl  deliberate  and  indeed  iniquitous  introduction  of  the  unfit 
into  the  commonwealth  is  unnecessary  and  unjust  to  both 
our  native  and  foreign-born  population,  and  should  be  for- 
ever prevented  by  the  most  drastic  legislation. 

"  There  is  no  wealth  but  life,"  says  Ruskin,  and  if,  as 
some  scientists  assert,  the  human  race  has  not  improved 
very  much  in  quality  in  the  last  hundred  years,  it  behooves 
us  to  take  most  positive  steps  to  prevent  a  decided  retrogres- 
sion during  the  next  century ;  and  inasmuch  as  the  constant 
depletion  in  the  ranks  of  the  fit  but  increases  the  danger  of 
multiplying  the  unfit,  we  have  in  the  next  few  years  just 
about  double  the  danger  to  .face  with  half  the  resources  with 
which  to  combat  it. 

Should  these  present-day  conditions  continue,  one  can 
predict  very  accurately  what  will  happen  in  the  future.  When 
a  people  or  a  race  is  lowered  in  its  character  and  efficiency, 
the  apex  of  its  grandeur  has  been  reached.  History  will 
repeat  itself.  Greece,  Rome,  and  Egypt  can  credit  their 


358  RACE  DECADENCE 

decline  and  downfall  largely  to  a  lowering  of  the  quality  of 
their  men.  Whether  we  as  a  nation  can  bring  any  radical 
changes  about  in  our  generation  is  problematical,  but  we 
should  put  forth  every  effort  toward  preventing  the  making 
of  our  own  problems  more  difficult  as  a  result  of  failure 
properly  to  control  immigration. 

The  nation  has  room  for  other  millions  of  mentally  and 
physically  sound  immigrants,  whom  it  can  well  afford  to 
protect  and  educate  from  an  economic  point  of  view.  The 
financial  resources  of  the  government  for  such  development 
and  education  should,  however,  not  be  curtailed  by  an  un- 
necessary and  finally  useless  expenditure  for  maintenance 
of  those  who  are  unfit  and  who  multiply  their  unfit  progeny 
in  such  alarming  proportions.  These  conditions  must  be 
squarely  met.  They  are  not  theories  but  well  authenticated 
facts.  They  cannot  be  ignored.  They  brush  aside  all  polit- 
ical considerations  and  become  a  most  vital  issue  of  the  day. 

DESIRABILITY   OF   RESTRICTIVE   EUGENICS 

To  sum  up  in  the  words  of  an  able  thinker : 

We  believe  that  there  are  urgent  reasons  for  and  no  objections 
to  preventing  the  reproduction  of  a  number  of  persons  in  the 
United  States,  many  of  whom  have  already  been  recognized  by 
society  as  being  so  antisocial  or  inferior  as  to  need  institutional 
care.  Such  restriction  can  best  be  enforced  by  effective  segregation 
of  the  sexes,  although  there  are  cases  where  individuals  might  well 
be  released  and  allowed  full  freedom,  either  "on  parole,"  so  to 
speak,  or  after  having  undergone  a  surgical  operation  which  would 
prevent  their  reproduction. 

Laws  providing  for  sterilization,  such  as  a  dozen  states 
now  possess,  are  not  framed  with  the  knowledge  of  the 
needs  of  the  case;  but  a  properly  drafted  sterilization  law 
to  provide  for  cases  not  better  treated  by  segregation  is 
desirable.  Segregation  should  be  considered  the  main  method 
at  present. 


RESTRICTING  THE  UNFIT  359 

It  is  practicable  to  place  only  minor  restrictions  on  mar- 
riage, with  a  eugenic  goal  in  view.  A  good  banns  law,  how- 
ever, could  meet  no  objections  and  would  yield  valuable 
results.  Limited  age  restrictions  are  proper. 

Marriages  of  individuals  whose  families  are  marked  by 
minor  taints  cannot  justify  social  interference;  but  an  en- 
lightened conscience  and  a  eugenic  point  of  view  should 
lead  every  individual  to  make  as  good  a  choice  as  possible. 

If  a  eugenically  bad  mating  has  been  made,  society  should 
minimize  as  far  as  possible  the  injurious  results,  by  means 
of  provision  for  properly  restricted  divorce. 

Consanguineous  marriages  in  a  degree  no  closer  than  that 
of  first  cousins,  are  neither  to  be  condemned  nor  praised  in- 
discriminately. Their  desirability  depends  on  the  ancestry 
of  the  two  persons  involved ;  each  case  should  therefore  be 
treated  on  its  own  merits.  Present-day  laws  regulating 
cousin  marriages  are  wholly  unscientific. 

Although  conditions  may  be  worse  in  the  older  and  more 
densely  populated  states,  it  is  probable  that  there  is  no  state 
in  the  union  which  has  not  many  families,  or  groups  of 
families,  of  this  dependent  type.  Half  a  dozen  well-defined 
areas  of  this  kind  have  been  found  in  Pennsylvania,  which 
is  probably  not  exceptional  in  this  respect. 

These  differ,  of  course,  in  extent  and  character  and  the  gravity 
of  the  problems  they  present.  In  some  there  is  great  sexual  laxity, 
which  leads  to  various  forms  of  dependency  and  sometimes  to  ex- 
treme mental  defect.  In  others  alcoholism  prevails  and  the  people 
show  a  propensity  for  deeds  of  violence.  All  informants,  however, 
practically  agreed  to  the  following  characterization: 

1.  Because   of    the   thefts   and    depredations   and    the    frequent 
applications  for  charitable  relief  from  such  sections  they  constitute 
a  parasitic  growth  which  saps  the  resources  of  the  self-respecting, 
self-sustaining  contingent  of  the  population. 

2.  They    furnish  an   undue   proportion  of   court  cases,   and  are 
thus  a  serious  expense  to  county  and  state. 

3.  They  are  a  source  of  physical  decay  and  moral  contamination, 
and  thus  menace  the  integrity  of  the  entire  social  fabric. 


360  RACE  DECADENCE 

THE   ETHICS    OF   RESTRICTIVE   EUGENICS 

We  think  the  time  has  come  when  but  few  persons  will 
argue  for  the  unqualified  right  of  two  manifestly  feeble- 
minded individuals  to  get  married  and  reproduce  themselves ; 
though  many  persons  might  claim  for  these  defectives  the 
right  to  marry  after  they  had  been  rendered  barren  by  steril- 
ization. There  are  several  ethical  angles  to  this  problem. 

/.  The  biologic  aspects. —  The  right  to  marry  is  commonly 
regarded  as  being  an  inalienable  right  of  the  individual  — 
that  is,  if  it  does  not  in  some  manner  seriously  conflict  with 
the  rights  of  society  —  the  welfare  of  the  race. 

The  companionship  of  two  persons  between  whom  true  love  ex- 
ists, is  beyond  all  question  the  highest  happiness  possible,  and  one 
which  society  should  desire  and  strive  to  give  its  every  member. 
On  that  point  there  will  be  no  difference  of  opinion,  but  when  it 
is  asked  whether  there  can  be  a  separation  between  the  comradeship 
aspect  and  the  reproduction  aspect,  in  marriage,  whether  any  in- 
terest of  the  race  can  justifiably  divorce  these  two  phases,  often  con- 
sidered inseparable,  protests  are  at  once  aroused.  In  these  protests, 
there  is  some  justice.  We  would  be  the  last  ones  to  deny  that  a 
marriage  has  failed  to  achieve  its  goal,  has  failed  to  realize  for  its 
participants  the  greatest  possible  happiness,  unless  it  has  resulted  in 
sound  offspring. 

That  word  "  sound  "  is  the  key  to  the  distinction  which 
must  be  made.  The  interests  of  the  race  demand  sound  off- 
spring from  every  couple  in  a  position  to  furnish  them  — 
not  only  in  the  interests  of  that  couple  —  interests  the  im- 
portance of  which  it  is  not  easy  to  overestimate  —  but  in 
the  interests  of  the  future  of  the  race,  whose  welfare  far 
transcends  in  importance  the  welfare  of  any  one  individual, 
•or  any  pair  of  individuals.  "As  surely  as  the  race  needs  a 
constant  supply  of  children  of  sound  character,  so  surely  is 
it  harmed  by  a  supply  of  children  of  inherently  unsound 
character,  physically  or  mentally,  who  may  contribute  others 
like  themselves  to  the  next  generation." 


RESTRICTING  THE  UNFIT  361 

In  view  of  these  facts,  one  writer  comments: 

The  Spartans  and  other  peoples  of  antiquity  fully  realized  this 
fact,  and  acted  on  it  by  exposing  deformed  infants.  Christianity 
properly  revolted  at  such  an  action;  but  in  repudiating  the  action, 
it  lost  sight  of  the  principle  back  of  the  action.  The  principle  should 
have  been  regarded,  and  civilized  races  are  now  coming  back  to  a 
realization  of  that  fact  —  are,  indeed,  realizing  its  weight  far  more 
fully  than  any  other  people  has  ever  done,  because  of  the  growing 
realization  of  the  importance  of  heredity.  No  one  is  likely  seriously 
to  argue  again  that  deformed  infants  (whether  their  deformity  be 
physical  or  mental)  should  be  exposed  to  perish;  but  the  argument 
that  in  the  interests  of  the  future  of  the  race  they  would  better  not 
be  born,  is  one  that  admits  of  no  refutation. 

2.  The  humanitarian  side. —  Here  we  encounter  our  most 
difficult  problems.     It  fires  our  charitable  vanity  and  satis- 
fies our  mental  ego  to  visit  the  children's  ward  in  a  large 
hospital  and  observe  how  tenderly  the  little  ones  are  cared 
for.     It  touches  our  hearts  to  talk  with  the  sensitive,  but 
devoted,    mother   of    some    feeble-minded   child;   but   not- 
withstanding all  of  our  mutual  "  heart-throbs  "  and  "  heart- 
aches "  —  we  must  admit  that  all  would  have  been  better  off 
if  most  of  these  defectives  and  deformed  children  had  never 
been  born.     Most  of  these  unfortunate  little  ones  will  grow 
up  regretting  that  they  were  ever  brought  into  the  world. 
We  are  not  unmindful  of  the  occasional  genius  who  may 
chance  to  be  crippled  physically  but  may  be  of  considerable 
service  to  society;  we  refer  to  the  more  clearly  defective 
and  degenerate  offspring  of  the  definitely  insane  and  feeble- 
minded parentage. 

3.  The  financial  aspects. —  We  have  already  referred  to 
the  enormous  economic  aspects  of  this  eugenic  problem. 

Except  students  of  eugenics,  few  persons  realize  how  stag- 
gering is  the  bill  annually  paid  for  the  care  of  defectives. 

The  amount  which  the  state  of  New  York  expends  yearly  on  the 
maintenance  of  its  insane  wards,  is  greater  than  it  spends  for  any 
other  purpose  except  education;  and  in  a  very  few  years,  if  its  in- 


362  RACE  DECADENCE 

sane  population  continues  to  increase  at  the  present  rate,  it  will 
spend  more  on  them  than  it  does  on  the  education  of  its  normal 
children. 

The  cost  of  institutional  care  for  the  socially  inadequate  is 
far  from  being  all  that  these  people  cost  the  state ;  but  those 
figures  at  least  are  not  based  on  guesswork.  The  annual 
cost J  of  maintaining  a  feeble-minded  ward  of  the  state,  in 
various  commonwealths,  is: 

Illinois    $136.50 

Indiana   147-49 

Minnesota    148.05 

Ohio    155-47 

Wisconsin    159-77 

Kansas   170.16 

Michigan    I79-42 

Kentucky  184.77 

California    208.97 

Maine 222.99 

At  such  prices,  each  state  maintains  hundreds,  sometimes 
thousands,  of  feeble-minded,  and  the  number  is  growing  each 
year.  In  the  near  future  the  expenditures  must  grow  much 
more  rapidly,  for  public  sentiment  is  beginning  to  demand 
that  the  defectives  and  delinquents  of  the  community  be 
properly  cared  for.  The  financial  burden  is  becoming  a 
heavy  one;  it  will  become  a  crushing  one  unless  steps  are 
taken  to  make  the  feeble-minded  less  productive. 

We  are  forced,  then,  to  recognize  that  from  every  stand- 
point, we  are  ethically  justified  in  contending  for  the  improve- 
ment of  human  society  by  working  for  the  lessened  produc- 
tion of  those  children  who  will  grow  up  to  become  unde- 
sirable citzens  —  eugenically.  The  authors  of  Applied 
Eugenics  reach  this  conclusion: 

Granted  that  such  prevention  is  a  proper  function  of  society,  the 
question  again  arises  whether  it  is  an  ethically  correct  procedure 

1  These  figures  were  compiled  by  the  National  Committee  for 
Mental  Hygiene. 


RESTRICTING  THE  UNFIT  363 

to  allow  these  potentially  undesirable  parents  to  marry  at  all.  Should 
they  be  doomed  to  perpetual  celibacy,  or  should  they  be  permitted 
to  mate,  on  condition  that  the  union  be  childless.  The  eugenic 
interests  of  society,  of  course,  are  equally  safeguarded  by  either 
alternative.  All  the  other  interests  of  society  appear  to  us  to  be 
better  safeguarded  by  marriage  than  by  celibacy.  Adding  the  in- 
terests of  the  individual,  which  will  doubtless  be  for  marriage,  it 
seems  to  us  that  there  is  good  reason  for  holding  such  a  childless 
marriage  ethically  correct,  in  the  relatively  small  number  of  cases 
where  it  might  seem  desirable. 

EUGENIC  EXAMINATIONS 

In  recent  years  we  have  heard  considerable  about  eugenic 
examinations  and  eugenic  marriages.  As  far  as  the  author 
is  acquainted  with  these  well-meant  efforts,  they  would  be 
more  properly  characterized  as  "  hygienic  "  than  eugenic. 
The  sex  hygienists,  we  believe,  are  more  responsible  for  these 
efforts  whether  educational  or  legislative.  Of  course,  every 
student  of  eugenics  wishes  them  well,  and  cannot  help  but  be 
interested  in  all  these  efforts  to  improve  society,  but  it  is 
unfortunate  that  so  many  of  these  reformatory  and  health 
efforts  have  become  confused  with  the  more  fundamental  pro- 
gram of  eugenics.  Let  us  encourage  all  this  sort  of  thing  — 
but  let  us  not  mistake  the  purpose. 

Most  of  the  laws  dealing  with  medical  examinations  as  a 
prerequisite  to  marriage  are,  on  the  whole,  of  that  sort  of 
legislation  which  may  be  loosely  termed  "half-baked"  — 
that  is,  it  is  not  fundamentally  correct,  and  usually  the  pro- 
visions made  for  its  enforcement  are  wholly  inadequate. 
These  laws,  if  they  could  be  properly  and  indiscriminately 
enforced,  would  be  good  for  society  as  a  means  of  prevent- 
ing the  spread  of  venereal  and  other  contagious  diseases, 
but  as  they  are  at  present  enforced  they  are  altogether  too 
easy  of  evasion.  It  should  be  further  borne  in  mind  that 
even  though  these  so-called  hygienic  statutes  had  a  eugenic 
value,  the  refusal  to  issue  a  marriage  license  is  not  able 


364  RACE  DECADENCE 

to  prevent  these  people  from  having  offspring,  it  merely 
denies  the  stamp  of  legitimacy  to  the  child. 

Let  us  welcome  these  so-called  eugenic  laws,  but  let  the 
reader  bear  thoroughly  in  mind  that  they  are  not  essential 
eugenic  measures.  They  certainly  are  of  educational  value 
in  that  they  awaken  the  public  to  a  consideration  of  the 
importance  of  giving  some  thought  to  the  individual's  con- 
dition and  status  before  he  is  permitted  to  enter  into  the 
marriage  relation,  and  so  when  viewed  in  this  light,  even 
eugenists  may  welcome  all  such  well-meant  efforts.  As 
with  all  other  endeavors  to  surround  the  marriage  rela- 
tion with  publicity  it  would  tend  to  dignify  matrimony 
and  to  deter  those  who  would  hastily  and  thoughtlessly  rush 
into  it.  All  laws,  such  as  requisition  for  parental  consent, 
presentation  of  birth  certificates,  and  even  a  revival  of  the 
banns,  would  be  acceptable  toward  improving  marriage 
laws.  We  believe  much  can  be  done  to  improve  our  mar- 
riage laws,  even  aside  from  the  more  fundamental  eugenic 
considerations  which  we  have  been  discussing. 

The  fundamental  defect  in  the  so-called  eugenic  exami- 
nation is  that  it  is  not  sufficiently  thorough,  either  in  regard 
to  its  efforts  to  detect  the  presence  of  venereal  infection  — 
syphilis  and  gonorrhea  —  or  in  its  efforts  to  disclose  the 
presence  of  tuberculosis  and  other  contagious  diseases. 
Neither  are  these  examinations  sufficiently  thorough  from  the 
standpoint  of  detecting  feeble-mindedness,  moronism,  or  ar- 
rested mental  development,  which  would  be  transmissible  to 
the  next  generation,  not  to  mention  the  thoroughness  of 
the  inquiries  which  should  be  directed  toward  the  detection 
in  the  family  strain  of  alcoholism,  insanity,  epilepsy,  etc. 
These  examinations  should  be  just  as  thoroughly  conducted 
with  reference  to  women  as  they  are  in  the  case  of  men.  The 
author's  attitude  toward  all  of  this  sort  of  agitation  and  leg- 
islation is  —  let  the  good  work  go  on.  As  a  rule  the  f  unda- 


RESTRICTING  THE  VNF1T  365 

mental  principles  are  good,  although  the  background  of  the 
legislation  is  immature,  the  examinations  inadequate  and  the 
laws  insufficiently  enforced ;  but  on  the  whole  the  agitation  is 
good,  the  education  is  beneficial,  even  though  the  legislation 
is  defective.  From  time  to  time  these  laws  will  be  revised, 
will  be  better  enforced,  the  public  sentiment  will  become  more 
intelligent,  and  they  may  be  the  forerunners  of  more  sound 
and  sane  eugenic  legislation  which  we  hope  will  be  adopted 
at  some  future  time. 


SUMMARY  OF  THE  CHAPTER 

1.  It  is  desirable  that  those  individuals  whose  offspring  is 
doomed  by  heredity  should  be  deprived  of  the  opportunity  or 
power  to  reproduce. 

2.  The  sanctity  of  "  personal  rights  "  is  not  a  sufficient 
reason  for  polluting  and  contaminating  the  race  as  a  whole. 

3.  In  case  of  uncertainty,  give  the  defective  individual  the 
benefit  of  the  doubt.    Many  defectives  will  voluntarily  decline 
to  reproduce,  if  they  are  properly  instructed. 

4.  The  ancients  quite  ignored  and  neglected  the  idiot.    The 
Christian  religion  has  inculcated  the  principle  of  charity  and 
kindness  regarding  the  treatment  of  these  and  similar  unfor- 
tunates. 

5.  At  first  revered  as  "  infants  of  the  good  God "  the 
feeble-minded  (in  earlier  times)  were  later  persecuted  as  evil 
spirits,  "  filled  with  Satan." 

6.  The  first  school  for  the  feeble-minded  was  founded  in 
France  in  1837. 

7.  The  restriction  program  of  eugenics  embraces:  educa- 
tion,  restrictive   legislation,   segregation,  and   surgery  —  in 
certain  cases. 

8.  The  operation  of  sterilization  is  greatly  and  widely  mis- 
understood.   It  does  not  unsex  the  individual,  whatever  the 
other  objections  may  be. 

9.  The  old  doctrines  of  "personal  liberty"  must  not  be 
allowed  to  stand  in  the  way  of  our  utilizing  the  laws  of 
heredity  for  the  improvement  of  the  race. 


366  RACE  DECADENCE 

10.  Eugenists  are  practical  and  sensible.     They  do  not 
propose  to  "  reduce  humanity  to  the  level  of  the  barnyard." 

11.  Eugenists   propose   no    more    restriction   than   those 
already  generally  applied  to  criminals  and  the  insane. 

12.  One  of  the  first  things  needed  for  race  betterment  is 
an  improvement  of  our  marriage  laws.    Restrictive  marriages 
are  desirable. 

13.  We  must  abandon  the  belief  that  good  environment  will 
atone  for  the  deficiencies  of  birth,  and,  therefore  bless  the 
offspring  of  any  sort  of  marriage. 

14.  Feeble-mindedness  and  other  sorts  of  defectiveness 
should  constitute  valid  grounds  for  divorce. 

15.  As  a  rule,  too  early  marriages  should  be  discouraged. 
They  favor  an  undue  increase  in  the  less  desirable  elements 
of  society. 

1 6.  Why  should  the  normal  classes  of  society  continue  — 
forever  —  to  support  an  increasing  group  of  hopeless  repro- 
ducing defectives  ? 

17.  That  these  defectives  hand  on  their  traits  to  the  next 
generation  is  abundantly  shown  by  a  study  of  the  "  Jukes  " 
or  the  "  Kallikaks." 

18.  The  immigrant  of  the  future  should  be  more  carefully 
scrutinized  from  the  standpoint  of  his  hereditary  tendencies 
and  weaknesses. 

19.  A  dozen  states  already  have  sterilization  laws  of  some 
sort.    Other  states  have  laws  looking  toward  improving  mar- 
riages.   The  dawn  of  restrictive  eugenics  has  come. 

20.  Cousin   marriages    depend   entirely   on   whether   the 
"stock"  is  sound  or  not.     If  the  heredity  is  good  —  there 
is  little  or  no  scientific  objection. 

21.  The  right  to  marry  is  not  inalienable.    When  the  off- 
spring is  sure  to  curse  society,  the  rights  of  future  genera- 
tions should  be  respected. 

22.  False   sympathy  and   "  humanitarian "   consideration 
should  not  deceive  us  into  approving  marriage  between  mani- 
festly defective  individuals. 

23.  Some  day  the  cost  of  caring  for  defectives  will  compel 
action.     Every  defective  costs  the  state  from  $150.00  to 
$250.00  a  year  for  care  alone. 

24.  So-called  eugenic   examinations   are   in   reality   only 


RESTRICTING  THE  UNFIT  367 

"  hygienic,"  having  to  do  with  present  health  —  and  not  the 
problem  of  inheritance. 

25.  Most  "  eugenic  examinations  "  are  inadequate,  and  the 
legislation  along  this  line  is  mostly  premature  and  "  half- 
baked." 

26.  So-called  eugenic  legislation  having  to  do  with  pre- 
marriage  medical  examinations  may  possibly  be  the  fore- 
runner of  more  thoroughgoing  laws  looking  towards  sci- 
entific race  betterment. 


CHAPTER  XXV 
LOOKING  FACTS  IN  THE  FACE 

WE  HAVE  completed  our  examination  of  the  data 
respecting  both  the  physical  and  mental  status  of 
present-day  civilization  in  general  and  the  American  people 
in  particular.  We  have  endeavored,  in  an  unbiased  manner, 
to  examine  the  evidence  and  interpret  the  facts  concerning 
the  whole  great  problem  of  race  degeneracy.  It  has  been 
our  intent  to  reach  conclusions  which  were  fair  and  to  formu- 
late opinions  which  were  unprejudiced,  and  while  we  began 
this  research  optimistic  and  hopeful  as  regards  the  future  of 
the  American  people,  we  cannot  look  all  the  assembled  facts 
in  the  face  and  not  experience  a  feeling  of  concern  regarding 
the  future  status  and  development  of  the  race. 

While  the  author  discerns  no  occasion  for  panic  or  hysteria ; 
while  the  immediate  welfare  and  continuity  of  the  race  is  not 
actually  and  seriously  threatened;  while  both  natural  and 
artificial  influences  already  may  be  working  in  a  small  way 
toward  correcting  some  of  the  evils  recognized ;  nevertheless, 
the  whole  picture  of  the  physical,  intellectual,  and  racial  status 
of  the  American  people  presents  a  group  of  problems  of  suffi- 
cient seriousness  and  gravity  to  challenge  sober  thought  and 
command  the  earnest  attention  of  every  serious-thinking 
American. 

Blind  optimism  and  ignorant  patriotism  will  avail  us  noth- 
ing in  meeting  the  issues  of  physical  decadence  or  in  stem- 
ming the  tide  of  mental  degeneracy.  A  blind  and  unreason- 
ing belief  in  a  magnificent  destiny  for  the  American  people 
will  not  serve  to  correct  or  remedy  the  ills  which  are  appear- 

368 


LOOKING  FACTS  IN  THE  FACE  369 

ing  in  our  body  politic  as  the  result  of  the  insidious  racial 
changes  which  are  slowly,  but  surely,  taking  place. 

As  compared  with  many  other  nations,  we  are  reasonably 
sound  and  our  future,  barring  the  passing  unrest  of  the 
hour,  would  seem  to  be  bright  and  hopeful;  but  such  satis- 
faction and  assurance  is  only  comparative,  for,  when  we  look 
into  the  actual  drift  of  things  American,  when  we  fearlessly 
face  .the  known  facts  in  the  case,  we  are  compelled  to  recog- 
nize that  all  is  not  well ;  that  Uncle  Sam  does  not,  to  a  suffi- 
cient degree,  possess  the  ideal  of  a  "  sound  mind  and  a  sound 
body."  The  scientific  study  of  our  physical,  mental,  and 
racial  status  discloses  sufficient  departure  from  the  ideals  of 
what  we  should  be  and  may  be,  to  arouse  in  every  sincere 
student  the  conviction  that  positive  effort  must  be  put  forth, 
in  the  very  near  future,  to  correct  the  existing  evils  which 
afflict  us  as  a  nation. 

HIGHEST  PATRIOTISM 

The  truest  patriotism  —  the  highest  citizenship  —  is  evi- 
denced not  by  blind  devotion  to  the  thought  of  our  national 
greatness  and  destiny,  but  rather  by  an  honest  willingness  to 
learn  the  truth,  sincerely  to  examine  the  facts,  and  then 
fearlessly  and  bravely  face  the  issue,  grapple  with  the  diffi- 
culties, and  by  perseverance  and  common  sense  seek  scien- 
tifically and  thoroughly  to  overcome  any  handicap  which  the 
errors  of  the  past  and  the  mistakes  of  former  generations 
may  have  placed  upon  the  people  of  the  present  day,  all  the 
while  keenly  recognizing  our  great  duty  so  to  conduct  our 
social,  political,  and  other  affairs  as  to  prevent  the  further 
handicapping  of  succeeding  generations  as  the  result  of  the 
passing  on  to  them  added  or  cumulative  burdens  of  the  same, 
or  a  worse,  nature  than  those  we  labor  and  suffer  under  at 
the  present  time. 

Philanthropy  and  altruism  need  a  new  birth  and  an  en- 


37°  RACE  DECADENCE 

larged  viewpoint.  While  we  would  not  stop  any  of  our  pres- 
ent-day efforts  to  relieve  suffering,  commiserate  misery,  or 
ameliorate  human  woe,  we  would  so  widen  the  horizon  of  the 
modern  philanthropist  that  he  would  recognize  that  much 
of  our  charitable  ministration  is  of  but  passing  value,  and 
that  it  contributes  little  or  nothing  to  elevating  the  race  — 
that  it  avails  not  a  thing  toward  the  uplifting  of  the  next 
generation.  The  time  has  come  for  the  powerful  forces  of 
science,  the  humanitarian  ministrations  of  the  physician,  and 
the  uplifting  efforts  of  the  reformer  to  coordinate  and  corre- 
late their  influence  —  to  recognize  that  we  have  long  since 
largely  lost  the  protection  of  the  operation  of  the  laws  of 
"  natural  selection "  and  that  we  are  threatened  with  the 
dire  consequences  of  our  failure  to  establish  some  sort  of 
"  artificial  selection,"  based  on  our  scientific  knowledge,  in 
some  measure  to  take  the  place  of  the  biologic  law  of  the 
"  survival  of  the  fittest,"  which  modern  civilization  is  so 
effectually  annulling. 

One  thing  is  certain,  if  we  do  not  give  willing  thought  to 
these  problems  of  race  decadence,  now  or  in  the  near  future, 
some  day  this  generation,  or  the  next,  will  be  forced  to  attend 
to  some  of  these  matters  with  haste  and  with  but  immature 
consideration;  whereas  now  the  threat  of  evil  is  far  enough 
away  to  permit  us  to  give  careful,  deliberate,  and  scientific 
consideration  to  the  problems  which  confront  us,  and  work 
out  painstaking  and  sane  methods  of  regulation,  suppression, 
prevention,  and  control.  Do  we  believe  that  prevention  is 
better  than  cure  ?  Do  we  not  believe  in  preparedness  in  any- 
thing as  regards  our  state  and  nation?  Will  the  American 
people  always  go  on  heedlessly  until  they  stand  on  the  brink 
of  a  precipice,  before  they  will  consent  to  discern  danger  and 
prepare  for  eventualities  ?  Can  we  not  open  our  eyes  and  see 
whither  we  are  drifting,  and  before  the  current  becomes  so 
swift  as  to  bear  us  dangerously  near  the  evil  shoals,  can  we 


LOOKING  FACTS  IN  THE  FACE  371 

not  reverse  the  engine  of  civilization,  or  at  least  stop  in  our 
national  activities  a  sufficient  length  of  time  to  take  stock,  to 
ascertain  the  truth,  to  assemble  the  facts,  and  then  having 
looked  them  squarely  in  the  face,  to  take  hold  of  our  health, 
eugenic,  and  racial  problems,  with  an  earnest  will  to  bring 
about  the  scientific  and  systematic  solution  of  the  difficulties 
which  they  present? 

THE  SOLEMN  CALL  TO  THINK 

American  conditions  call  for  study  —  for  thought.  The 
facts  heretofore  presented  demand  recognition.  The  prob- 
lems of  the  hour  challenge  our  sincere  study.  Our  national 
life  needs  to  be  studied  in  the  light  of  the  rise  and  down- 
fall of  other  nations.  We  are,  as  governments  go,  but  a 
young  people,  and  now  is  the  time,  in  our  adolescence  as 
it  Avrere,  carefully  to  take  stock,  earnestly  to  inquire  into 
and  recognize  our  fundamental  defects,  and  then  with  that 
patriotic  courage  and  stalwart  bravery  born  of  the  optimism 
and  national  confidence  which  has  for  'its  foundation  that 
body  of  accumulated  scientific  facts  and  biologic  wisdom 
which  is  the  heritage  of  the  dawn  of  the  twentieth  century, 
let  us  as  one  man  consecrate  our  hands  to  the  task  and 
dedicate  our  minds  to  the  cause  of  turning  away  the  menac- 
ing tide  of  physical  decadence  and  mental  defectiveness, 
before  this  dire  threat  of  degeneracy  shall  have  time  to 
assume  more  serious  proportions,  and  before  the  racial 
deterioration  which  now  looms  in  the  distance  shall  have 
further  undermined  the  stability  and  intellectual  greatness 
of  America  and  Americans. 

The  call  now  to  the  citizenry  of  America  is  for  the  read- 
ing, thinking  half  to  become  students  of  the  great  problem 
of  race  betterment:  to  formulate  their  ideas,  revise  their 
opinions,  reach  their  conclusions,  and  then  in  turn  become 
teachers  of  the  other,  the  unthinking,  heedless,  and  careless 


372  RACE  DECADENCE 

half,  that  is  driving  on  heedlessly  toward  racial  decadence 
and  national  ruin.  This  is  the  age,  today  is  the  time,  for 
education  and  agitation.  Tomorrow,  perhaps  even  another 
generation,  may  be  the  time  for  the  more  drastic  legislation 
which  shall  seek  to  purify  our  stream  of  national  life.  We 
must  possess  more  knowledge,  and  more  people  must  possess 
the  knowledge  which  we  today  have,  before  we  can  begin 
the  more  sure  and  positive  purging  of  the  nation  by  cor- 
rective legislation.  But  today  we  already  know  enough  of 
heredity,  we  already  are  aroused  —  at  least  a  thinking 
minority  is  sufficiently  aroused  —  concerning  the  menace 
of  decadence  and  the  threat  of  degeneracy,  as  to  make 
certain  that  the  time  has  come,  the  hour  has  struck,  to 
sound  the  rallying  call,  to  blow  the  bugle  for  the  summons 
into  action  of  the  men  and  women  who  have  dared  to 
uncover  the  causes  which  are  operating  to  threaten  our 
national  integrity;  and  who  are  willing  to  face  the  facts 
which  so  unerringly  point  out  our  slow  but  sure  drift  toward 
national  degeneracy.  Yes,  the  hour  is  here  to  sound  the  rally- 
ing call  for  that  part  of  our  citizenry  which  is  willing 
to  *'  look  the  facts  in  the  face  "  and  then  with  intelligence 
and  determination  lay  the  ax  of  prevention  to  the  root  of 
the  tree  which  is  responsible  for  this  increasing  harvest  of 
human  unfitness,  defectiveness,  and  degeneracy. 


The  reader  may  be  interested  in  knowing  that  this  book 
on  "  Race  Decadence  "  is  the  first  of  a  series  of  four  vol- 
umes which  will  cover,  in  their  discussions,  the  whole 
field  of  Race  Hygiene  in  general  and  the  racial  status  and 
prospects  of  the  American  people  in  particular.  This  series 
of  books  will  cover  the  fields  of  race  degeneracy,  heredity, 
eugenics,  and  the  more  direct  application  of  these  biologic 
facts  to  the  present  problems  of  the  American  people,  in- 
cluding a  study  of  immigration  in  relation  to  eugenics. 


LOOKING  FACTS  IN  THE  FACE  373 

Briefly  outlined,  these  volumes  will  cover  these  subjects 
in  a  manner  somewhat  after  the  following  scheme: 

Vol.  I.  Race  Decadence. —  This  phase  of  Race  Hygiene 
is  covered  in  the  present  volume. 

Vol.  II.  Genetics:  Th*  Science  of  Heredity. —  The 
subject  of  genetics  will  be  covered  in  the  second  vol- 
ume of  this  series,  which  fully  discusses  the  laws  of  in- 
heritance as  applied  to  plants,  animals,  and  the  human  species, 
presenting  a  practical,  popular,  and  scientific  portrayal  of 
this  extremely  interesting  subject. 

Vol.  III.  Race  Betterment;  or,  Applied  Eugenics. —  This 
volume  will  be  devoted  to  making  a  practical  application  of 
the  laws  of  heredity  to  the  human  race.  It  will  present  a 
full  and  frank  discussion  of  eugenics,  with  a  sane  and  prac- 
tical program  for  Race  Betterment.  It  will  present  the 
medical  man's  view  of  the  problem  of  Race  Hygiene. 

Vol.  IV.  American  Problems. —  Lastly,  the  fourth  vol- 
ume will  take  up  the  sociological,  educational,  industrial, 
and  political  aspects  of  Race  Hygiene  in  relation  to  the 
American  people.  This  volume  will  give  careful  considera- 
tion to  the  problems  of  immigration,  philanthropy,  and  other 
sociological  and  reformatory  questions  in  their  relation  to  ap- 
plied eugenics. 


APPENDICES 


APPENDIX  A 


TABLE  NO.    I 

DEATH-RATE  IN  THE  UNITED  STATES.  PER  1.000  OF  POPULATION 
FROM  1907  TO  1917 


Calendar  Year 

Deaths  from  all  causes* 
Registration  areaf 

Number 

Rate  per  1,000 
population 

1917.  . 

1,068.932 
1,001.921 
909,155 
898.059 
890,848 
838,251 
839.284 
805.412 
732,538 
691.574 
687,034 

14.2 
14.0 
13.5 
13.6 
14.1 
13.9 
14.2 
15.0 
14.4 
14.8 
16.0 

1916  

1915  

1914  

1913  

1912  

1911  

1910  

1908 

1907  

*Exclusive  of  stillbirths, 
t Exclusive  of  Hawaii. 


TABLE  NO.  2 
CAUSES  OF  DEATH  IN  THE  REGISTRATION  AREA  (1917) 


Cause 

Number 

Rate  per 
100.000  popu- 
lation 

Per  cent  of 
total 

All  causes  

1,068,932 

1419.4 

100.0 

Organic  diseases  of  the  heart.  .  . 
Pneumonia  (all  forms)    

115.337 
112,821 
110.285 
97,047 
6,092 
7,146 
81,903 
11,114 
10,056 

8,649 
6,830 

6,724 
5.781 
5,550 

153.2 
149.8 
146.4 
128.9 
8.1 
9.5 
108.7 
14.8 
13.4 

11.5 
9.1 

8.9 

7.7 

7.4 

9.1 
0.6 
0.6 

1.0 
0.9 

0.8 
0.6 

0.6 

0.5 
0.5 

10.8 
10.5 
10.3 

7.6 

Tuberculosis  (all  forms)  

Of  the  lungs  

•    Meningitis  

Other  forms  

External  causes  

Accidental  falls  

Suicide  

Railroad    accidents    and    in- 
juries   .          

Burns  (excluding  those  due  to 
conflagrations)  

Automobile  accidents  and  in- 
juries   

Homicide  

Accidental  drowning  

377 


378 


RACE  DECADENCE 


CAUSES  OF  DEATH  IN  THE  REGISTRATION  AREA  (1917)— Continued 


Cause 

Number 

Rate  per 
100,000  popu- 
lation 

Per  cent  of 
total 

External  causes  —  continued. 
Accidental  absorption  of  dele- 
terious gases  except  in  con- 
flagrations   

3,375 

4  5 

0  3 

Mine  accidents  and  injuries.  . 
Injuries  by  vehicles  other  than 
railroad   cars,    street   cars, 
and  automobiles  

2,623 
2,326 

3.S 
3  1 

0.2 
0  2 

Street  car  accidents  and  in- 
juries   

2,227 

3  0 

0.2 

Machinery  accidents  and  in- 
juries ...        

2,112 

2  8 

0.2 

Effects  of  heat   (other  than 
burns)  

1,964 

2.6 

0.2 

Other  external  causes  

12,572 

16  7 

1.2 

Acute    nephritis    and    Bright's 
disease  

80,912 

107.4 

7.6 

Cerebral  hemorrhage  (apoplexy) 
Cancer  

62,431 
61.452 

82.9 
81.6 

5.9 

5  8 

Diarrhea  and  enteritis  

59,504 

79  0 

5  6 

Congenital    debility    and    mal- 
formations   

56,973 

7S.7 

5.3 

Arterial   diseases  —  atheroma, 
aneurism,  etc  

19,055 

25.3 

1.8 

Influenza  

12,974 

17.2 

1.2 

Diabetes  

12,750 

16  9 

1  2 

Diphtheria  

12,453 

16.5 

1.1 

Bronchitis  

12,311 

16.3 

1.1 

Measles  

10,745 

14  3 

1.0 

Typhoid  fever  

10,113 

13.4 

0.9 

Appendicitis  and  typhlitis    .    .  . 

9,429 

12  5 

0  9 

Respiratory  diseases  other  than 
pneumonia  and  bronchitis  .  .  . 
Hernia  and  intestinal  obstruc- 
tions   

9,238 
8,677 

12.3 
11.5 

0.9 
0.8 

Cirrhosis  of  the  liver  

8,569 

11.4 

0.8 

7,837 

10.4 

0.7 

Puerperal  affections  other  than 
puerperal  septicemia  

7.317 

9.7 

0.7 

Meningitis  

6,890 

9.1 

0.6 

Rheumatism  

4,456 

5.9 

0.4 

Scarlet  fever  

3.141 

4.2 

0.3 

Erysipelas  

2,866 

3.8 

0.3 

Malaria  

2,387 

3.2 

0.2 

All  other  defined  causes. 

152.496 

202  5 

14.3 

Unknown  or  ill-defined  causes.. 

13.610 

18.1 

1.3 

While  the  registration  area  of  the  United  States  embraces 
only  about  three- fourths  of  the  country,  the  statistics  which  it 
yields  are  taken  as  the  basis  for  estimating  the  death-rates 
and  compiling  the  vital  statistics  for  the  whole  country. 


APPENDIX  A 


379 


TABLE    NO.   3 
LIFE  EXPECTANCY  TABLES 


Age  interval 

Of  100,000  persons  born 
alive 

Late  of  mortality 
per  1,000 

Complete  expec- 
tation of  life 

Number  dying  in 

\verage  length  of 

Period  of  life- 

age interval 

life  remaining  to 

time  between 

among  1,000 

each   one   alive 

two  exact 
ages 

slumber  alive  at 
beginning  of 
age  interval 

slumber    dying 
in  age  interval 

alive   at   begin- 
ning   o  f    a  g  e 
interval 

at  beginning  of 
age  interval 

Years 

Annual  rate 

In  years 

0-1 

100,000 

11,462 

114.62 

51.49 

1-2 

88,538 

2,446 

27.62 

57.11 

2-3 

86,092 

1,062 

12.34 

57.72 

3-4 

85,030 

666 

7.83 

57.44 

4-5 

84.364 

477 

5.65 

56.89 

5-6 

83.887 

390 

4.66 

56.21 

6-7 

83,497 

327 

3.91 

55.47 

7-8 

83.170 

274 

3.30 

54.69 

8-9 

82,896 

234 

2.82 

53.87 

9-10 

82,662 

204 

2.47 

53.02 

10-11 

82,458 

187 

2.27 

52.15 

11-12 
12-13 
13-14 

82,271 
82,091 
81,909 

180 
182 
193 

2.19 
2.22 
2.36 

51.26 
50.37 
49.49 

14-15 

81,716 

210 

2.57 

48.60 

15-16 

81,506 

232 

2.84 

47.73 

16-17 

81.274 

256 

3.16 

46.86 

17-18 
18-19 

81,018 
80,733 

285 
315 

3.52 
3.89 

46.01 
45.17 

19-20 

80,418 

344 

4.28 

44.34 

20-21 

80.074 

375 

4.68 

43.53 

21-22 

79,699 

398 

5.00 

42.73 

22-23 
23-24 
24-25 

79,301 
78,889 
78.471 

412 
418 
425 

5.19 
5.29 
5.42 

41  .94 
41.16 
40.38 

25-26 
26-27 
27-28 

78.046 
77.614 
77,174 

432 
440 
451 

5.54 
5.67 
5.85 

39.60 
38.81 
38.03 

28-29 
29-30 

76.723 
76,258 

465 
479 

6.06 
6.28 

37.25 
36.48 

30-31 
31-32 
32-33 
33-34 
34-35 

75.779 
75,286 
74,775 
74,245 
73,695 

493 
511 
530 
550 
568 

6.51 
6.78 
7.09 
7.40 
7.72 

35.70 
34.93 
34.17 
33.41 
32.66 

35-36 
36-37 
37-38 
38-39 
39-40 

73.127 
72.539 
71,934 
71,317 
70,686 

588 
605 
617 
631 
644 

8.04 
8.33 
8.59 
8.84 
9.11 

31.90 
31.16 
30.42 
29.68 
28.94 

RACE  DECADENCE 


LIFE  EXPECTANCY  TABLES— Continued 


Age  interval 

Of  100,000  persons  born 
alive 

Rate  of  mortality 
per  1,000 

Complete   expec- 
tation of  life. 

Period  of  life- 
time between 
two  exact 
ages 

Number  alive  at 
beginning  of 
age  interval 

Number    dying 
in  age  interval 

Number  dying  in 
age  interval 
among  1,000 
alive   at    begin- 
ning   of    age 
interval 

Average  length  of 
life  remaining  to 
each   one   alive 
at  beginning  of 
age  interval 

Years 

Annual  rate 

In  years 

40-41 

70,042 

658 

9.39 

28.20 

41-42 

69,384 

674 

9.72 

27.46 

42-43 

68,710 

693 

10.09 

26.73 

43-44 

68,017 

716 

10.52 

25.99 

44-45 

67,301 

740 

10.99 

25.  26 

l[45-46 

66,561 

766 

11.52 

24.54 

46-47 

65.795 

795 

12.08 

23.82 

47-48 

65,000 

821 

12.63 

23.10 

48-49 

64,179 

846 

13.18 

22.39 

49-50 

63.333 

873 

13.77 

21.69 

50-51 

62,460 

897 

14.37 

20.98 

51-52 

61,563 

929 

15.08 

20.28 

52-53 

60,634 

970 

16.01 

19.58 

53-54 

59,664 

1,025 

17.17 

18.89 

54-55 

58.639 

1.084 

18.49 

18.21 

55-56 

57,555 

1,153 

20.03 

17.55 

56-57 

56,402 

1,225 

21.72 

16.90 

57-58 

55,177 

1,289 

23.37 

16.26 

58-59 

53,888 

1,346 

24.97 

15.64 

59-60 

52.542 

1,404 

26.73 

15.03 

60-61 

51,138 

1,462 

28.58 

14.42 

61-62 

49,676 

1,521 

30.62 

13.83 

62-63 

48,155 

1,587 

32.96 

13.26 

63-64 

46.568 

1,656 

35.55 

12.69 

64-65 

44,912 

1.718 

38.25 

12.14 

65-66 

43,194 

.773 

41.06 

11.60 

66-67 

41,421 

,826 

44.08 

11.08 

67-68 

39,595 

,877 

47.41 

10.57 

68-69 

37,718 

,928 

51.12 

10.07 

69-70 

35.790 

.974 

55.14 

9.58 

70-71 

33,816 

2.013 

59.52 

9.11 

71-72 

31,803 

2,044 

64.29 

8.66 

72-73 

29,759 

2,065 

69.38 

8.22 

73-74 

27,694 

2,072 

74.82 

7.79 

74-75 

25,622 

2.070 

80.78 

7.38 

75-76 

23.552 

2,057 

87.37 

6.99 

76-77 

21,495 

2,028 

94.35 

6.61 

77-78 

19,467 

1,981 

101.74 

6.25 

78-79 

17,486 

1,920 

109.78 

5.90 

79-80 

15,566 

1.854 

119.10 

5.56 

80-81 

13.712 

1,786 

130.28 

5.25 

81-82 

11,926 

1,696 

142.17 

4.96 

82-83 

10,230 

1.565 

153.06 

4.70 

83-84 

8,665 

1,409 

162.58 

4.45 

84-85 

7.256 

1,255 

172.97 

4.22 

APPENDIX  A 
LIFE  EXPECTANCY  TABLES-Continued 


38i 


Age  interval 

Of  100.000  persons  born 
alive 

Rate  of  mortality 
per  1,000 

Complete  expec- 
tation of  life 

Period  of  life- 
time between 
two  exact 
ages 

« 

Number  alive  at 
beginning  of 
age  interval 

Number    dying 
in  age  interval 

Number  dying  in 
age  interval 
among   1,000 
alive   at   begin- 
ning   of    age 
interval 

Average  length  of 
life  remaining  to 
each   one   alive 
at  beginning  of 
age  interval 

Years 

Annual  rate 

In  years 

85-86 

6,001 

1,103 

183.80 

4  00 

86-87 

4,898 

954 

194.85 

3  79 

87-88 

3,944 

816 

206.84 

3.58 

88-89 

3,128 

689 

220.13 

3  39 

89-90 

2,439 

571 

234.31 

3.20 

90-91 

1,868 

466 

249.62 

3.03 

91-92 

1,402 

371 

,     264.66 

2.87 

92-93 

1,031 

289 

279.90 

2.73 

93-94 

742 

219 

295.12 

2.59 

94-95 

523 

162 

310.17 

2.47 

95-96 

361 

117 

325.02 

%  2.35 

96-97 

244 

83 

339.74 

2.24 

97-98 

161 

57 

354.55 

2.14 

98-99 

104 

39 

369.73 

2.04 

•99-100 

65 

25 

385.46 

1.95 

100-101 

40 

16 

401.91 

.85 

101-102 

24 

10 

419.14 

.76 

102-103 

14 

6 

437.37 

.67 

103-104 

8 

4 

456.77 

.59 

104-105 

4 

2 

477.48 

.50 

105-106 

2 

1 

500.22 

.41 

106-107 

1 

1 

524.82 

.33 

There  are  numerous  methods  of  figuring,  or  estimating, 
the  average  length  of  human  life — all  of  which  are  more 
or  less  faulty.  After  giving  due  consideration  to  the  objec- 
tions which  may  be  urged  against  the  several  ways  of  cal- 
culating the  duration  of  life,  this  plan  of  the  Life  Expectancy 
Table  seems  to  be  the  most  practical  and  reliable. 

In  this  connection  it  may  be  well  to  remind  the  reader 
that  the  "  health  span  "  of  life,  for  the  average  American,  is 
only  ten  years.  No  matter  how  long  we  may  live  —  on  the 
average  —  we  can  only  expect  to  enjoy  ten  years  of  perfect 
health. 


382 


RACE  DECADENCE 


TABLE   NO.   4 
DEATH-RATES  AT  DIFFERENT  AGES  IN  THE  REGISTRATION  AREA 


Deaths  from  all  causes  * 

Registration  areaf  1917 

Age  of  decedent 

Number 

Distribution  per  1,000 

Total 

Male 

Female 

Total 

Male 

Female 

All  ages     

1,068,932 

587,309 

481,623 

1,000.0 

1,000.0 

1,000.0 

Under  1  year  

171,024 

96,951 

74,073 

160.0 

165.1 

153.8 

1  year  

37,638 

20,127 

17,511 

35.2 

34.3 

36.4 

2  years  

16,893 

8,903 

7,990 

15.8 

15.2 

16.6 

3      ••       

10,520 

5,563 

4,957 

9.8 

9.5 

10.3 

4      "       

7.633 

3,997 

3,636 

7.1 

6.8 

7.S 

Under  S  years  

243,708 

135,541 

108,167 

228.0 

230.8 

224.6 

5  to    9  years 

23,070 

12,408 

10,662 

21.6 

21.1 

22.1 

10 

14 

16,088 

8,443 

7,645 

15.1 

14.4 

15.9 

15 

19 

26,049 

13,324 

12,725 

24.4 

22.7 

26.4 

20 

24 

39,101 

20.590 

18,511 

36.6 

35.1 

38.4 

25 

29 

41,732 

22.765 

18,967 

39.0 

38.8 

39.4 

30 

34 

43,121 

24,442 

18,679 

40.3 

41.6 

38.8 

35 

39 

47.572 

27.469 

20,103 

44.5 

46.8 

41.7 

40 

44 

48,665 

28,750 

19,915 

45.5 

49.0 

41.3 

45 

49 

52.485 

31.352 

21.133 

49.1 

53.4 

43.9 

50 

54 

57,318 

34,002 

23,316 

53.6 

57.9 

48.4 

55 

59 

62,428 

36,353 

26.075 

58.4 

61.9 

54.1 

60 

64 

67,500 

38,401 

29,099 

63.1 

65.4 

60.4 

65 

69 

72,225 

39,751 

32.474 

67.6 

67.7 

67.4 

70 

74 

74.303 

39,436 

34.867 

69.5 

67.1 

72.4 

75 

79 

65,891 

33,336 

32,555 

61.6 

56.8 

67.6 

80 

84 

48,469 

23,256 

25,213 

45.3 

39.6 

52.4 

85 

89 

25,280 

11,433 

13,847 

23.6 

19.5 

28.8 

90 

94 

8,985 

3.748 

5.237 

8.4 

6.4 

10.9 

95 

•  99 

2,152 

826 

1,326 

2.0 

1.4 

2.8 

100  years  and  over 

754 

285 

469 

0.7 

0.5 

1.0 

Unknown  

2,036 

1,398 

638 

1.9 

2.4 

1.3 

*  Exclusive  of  stillbirths. 
t  Exclusive  of  Hawaii. 

CENSUS  STATISTICS  FROM  1850  TO 

The  following  table  shows  the  number  of  insane  persons 
enumerated  at  each  census  from  1850  to  1910,  those  in  insti- 
tutions for  the  insane  and  those  outside  such  institutions 
being  shown  separately  for  the  censuses  of  1880  and  1890. 
Prior  to  1880  no  separate  return  was  made  of  the  insane 
in  institutions ;  and  since  1890,  no  enumeration  has  been  made 
of  the  insane  outside  of  institutions. 


APPENDIX  A 


383 


TABLE  NO.  5 
INSANE  ENUMERATED  AT  EACH  CENSUS  FROM  1850  TO  1910 


Year 

Insane  enumerated  in 
institutions  for 
the  insane 

Insane  enumerated 
outside  such 
institutions 

Total  Insane 
enumerated 

Number 

Per 
100,000 
population 

Number 

Per 

100.000 
population 

Number 

Per 

100,000 
population 

1910          

187,791 
150,151 
74.028 
40,942 

204.2 
183.6 
118.2 
81.6 

* 
* 
32,457 
51.017 

* 
* 
51.8 
101.7 

187.791 
150,151 
106,485 
91.959 
t    37.432 
t    24.042 
t    15.610 

204.2 
183.6 
170.0 
183.3 
t    97.1 
t    76.5 
t    67.3 

1904  

1890        .  . 

1880   

1870 

1860 

1850  

*  No  enumeration  of  insane  outside  of  institutions. 

5  Included  in  the  enumeration,  but  not  returned  separately. 
Enumeration  believed  to  have  been  seriously  deficient. 

TABLE    NO.   6 
INSANE  OF  VARIOUS  AGES  IN  THE  UNITED  STATES.  1910 


1 

Age  group 

Total 
population 
1910 

Insane  in  hospitals,  1910 

Enumerated  on 
January  1 

Admitted  during 
the  year 

Number 

Per 
100,000 
population 

Number 

Per 
100.000 
population 

All  ages  

91.972,266 

187.791 

204.2 

60,769 

66.1 

Under  15  years  

29,499.136 
9,063.603 
9,056.984 
8.180.003 
6,972,185 
6,396,100 
5.261.587 
4.469,197 
3.900.791 
2,786.951 
2,267.150 
1.679.503 
1.113.728 
667,302 
488,991 
169.055 

341 
2,312 
7,801 
14,083 
19,091 
22,856 
23,321 
22,874 
20,885 
16,383 
12,729 
9,545 
6,263 
3.596 
2,477 
3,234 

1.2 
25.5 
86.1 
172.2 
273.8 
357.3 
443.2 
511.8   . 
535.4 
587.8 
561.5 
568.3 
562.3 
539.9 
506.6 

327 
2,539 
5.701 
7.027 
7.295 
7.495 
6.469 
5,681 
4.877 
3.368 
2,872 
2,191 
1.776 
1.180 
1.014 
957 

1.1 

28.0 
62.9 
85.9 
104.6 
117.2 
122.9 
127.1 
125.0 
120.8 
126.7 
130.5 
159.5 
176.8 
207.4 

20       24      "    

25       29            

30       34           

35       39            

40       44           

45       49            

50       54            

55       59            

60       64            

65       69            

70       74            

75       79            

80  years  and  over  
Age  unknown  

The  classification  by  five-year  age  groups  shows  that  the 
number  of  inmates  enumerated  in  hospitals  for  the  insane  on 
January  i,  1910,  was  larger  in  each  successive  older  group  up 
to  the  age  of  45.  After  that  the  number  falls  off  slowly  at 


384  RACE  DECADENCE 

first  and  then  more  rapidly.  The  ratio  of  inmates  to  total 
population,  however,  shows  an  uninterrupted  increase  up  to 
the  age  of  60,  reaching  its  maximum  in  the  age  period  55  to 
59,  in  which  period  the  number  of  inmates  per  100,000  popu- 
lation is  587.8.  This  means  that  at  that  period  of  life  about 
i  person  in  170  is  an  inmate  of  a  hospital  for  the  insane. 
The  ratio  declines  somewhat  but  not  very  greatly  in  the  older 
age  periods.  In  the  population  80  years  of  age  and  over  it 
is  506.6  to  100,000,  or  i  to  197.  As  each  generation  grows 
older  the  ranks  of  the  insane  which  it  includes  are  of  course 
being  continually  recruited  by  new  cases  of  insanity;  on  the 
other  hand,  they  are  being  depleted  by  deaths,  and,  so  far  as 
concerns  the  insane  in  hospitals,  by  discharges  also.  The 
death-rate,  being  much  higher,  for  the  insane  than  for  the 
total  population,  is  a  factor  which  tends  to  reduce  the  ratio 
of  hospital  inmates  to  total  population  in  the  older-age 
periods ;  but  as  indicated  by  the  statistics,  its  influence  up  to  a 
certain  point  in  the  age  scale  is  more  than  offset  by  the  in- 
creasing ratio  of  admissions  representing  new  cases  of 
insanity. 

It  will  probably  require  at  least  another  generation  before 
we  will  have  our  insane  and  defective  population  sufficiently 
institutionalized  to  render  our  statistics  accurate  and  reliable. 
The  rapid  statistical  increase  in  insanity  in  recent  decades 
is,  no  doubt,  more  or  less  due  to  the  increasing  tendency 
to  place  this  sort  of  individual  in  the  custody  of  our  state 
hospitals  and  asylums.  At  some  future  time  this  custom 
will  have  reached  the  maximum  practice  and  from  that 
time  on  the  increase  in  our  insanity  figures  will  more  nearly 
represent  an  actual  gain  than  they  do  at  the  present  time. 
Accordingly,  we  should  expect  —  in  the  near  future  —  to 
see  a  declining  tendency  in  the  statistics  having  to  do  with 
the  number  of  insane  admitted  each  year  into  our  state 
institutions. 


APPENDIX  A 


385 


INSANITY  IN  DIFFERENT  SECTIONS  OF  THE  UNITED  STATES 

The  following  table  indicates  the  variations  in  the  relative 
importance  of  some  of  these  factors  in  different  sections  of 
the  United  States.  It  shows,  for  instance,  that  in  New  Eng- 
land 83.3  per  cent  of  the  total  population  in  1910  was  urban, 
27.9  per  cent  foreign  born,  5.5  per  cent  born  in  other  parts  of 
the  United  States,  27.2  per  cent  under  15  years  of  age,  and 
5.9  per  cent  65  years  and  over,  and  that  the  number  of  males 
to  100  females  in  the  total  population  was  99.3.  Without 
attempting  at  this  point  to  trace  out  or  establish  any  causal 
relationship  between  the  ratios  and  percentages  presented  in 
this  table,  attention  may  be  called  to  the  fact  a  high  ratio 
of  insane  in  institutions  appears  to  be  associated  with  a  rela- 
tively high  percentage  of  urban  population  and  of  foreign 
born,  and  with  a  relatively  small  percentage  of  children  and  a 
relatively  high  percentage  of  old  people.  It  may  be  further 
noted  that  the  sex  ratios,  given  in  the  last  column  of  the  table, 
appear  to  be  independent  of  the  variation  in  the  ratios  of  the 
insane. 

TABLE  NO.  7 
INSANITY  IN  DIFFERENT  SECTIONS  OF  THE  UNITED  STATES 


Division 

Insane    in   hos- 
pitals per 
100.000 
population 

Per  cent  of  total  population 
1910 

Males  to  100  fe- 
males in  the  total 
population 

Enu- 
merated 
on 
January 
1.  1910 

Ad- 
mitted 
in 
1910 

Urban 

For- 
eign 
born 

Born 
in 
other 
divi- 
sions 

Under 
15 
years 
of  age 

65 
years 
of  age 
and 
over 

United  States  

New  England  
Middle  Atlantic  
East  North  Central.  .  . 
West  North  Central  .  . 
South  Atlantic  

204.2 

66.1 

46.3 

14.7 

32.1 

4.3 

106.0 

99.3 
103.3 
106.0 
109.9 
101.2 
101.9 
107.2 
127.9 
129.  S 

298.8 
271.2 
226.0 
194.9 
163.6 
116.0 
95.8 
135.7 
243.4 

106.6 
75.9 
72.3 
64.1 
55.1 
43.8 
33.8 
61.6 
82.6 

83.3 
71.0 
52.7 
33.3 
25.4 
18.7 
22.3 
36.0 
56.8 

27.9 
25.1 
16.8 
13.9 
2.5 
1.0 
4.0 
17.2 
22.8 

5.5 
4.9 
9.3 
20.2 
4.7 
7.3 
23.3 
40.2 
40.3 

27.2 
29.0 
29.6 
31.9 
37.5 
38.1 
38.8 
31.1 
24.3 

5.9 
4.4 

5.1 
4.6 
3.6 
3.5 
2.8 
3.0 
4.5 

East  South  Central.  .  . 
West  South  Central.  . 
Mountain..          ..... 

Pacific  

RACE  DECADENCE 


THE  PHYSICALLY  DEFECTIVE  AMONG  FEEBLE-MINDED 

The  following  table  gives  the  percentage  of  physically 
'defective  in  the  several  geographic  divisions.  It  may  be 
noted  that  the  percentages  in  the  New  England  and  the  Mid- 
dle Atlantic  divisions  are  considerably  lower  than  in  most  of 
the  other  divisions,  and  probably  reflect  differences  in  the 
extent  to  which  provision  has  been  made  for  the  care  of 
defectives  in  special  institutions.  Such  statistics  are  also 
more  or  less  influenced  by  migratory  and  other  local  tenden- 
cies. The  effectives  emigrate  —  the  defectives  stay  at  home. 


TABLE  NO.  8 

FEEBLE-MINDED  IN  INSTITUTIONS  — PERCENTAGE  REPORTED 
AS  PHYSICALLY  DEFECTIVE 


Division 

Total 

Blind 

Deaf 

Crippled, 

maimed, 
or  de- 
formed 

Para- 
lytic 

Epi- 
leptic 

Two  or 
more 
defects 

United  States  

Enumerated  on  January  1 

25.3 

0.6 

1.4 

4.7 

2.9 

11.08 

3.9 

New  England    

17.3 
16.7 
29.6 
33.2 
39.2 
20.6 
47.4 
16  9 

0.8 
0.3 
0.6 
0.7 
0.9 
0.9 
10.5 

1.8 
0.8 
1.3 
1.7 
0.7 

2.5 
4.3 
6.5 
4.6 
4.3 
2.1 
15.8 
1.3 
2.3 

4.6 
1.9 
3.4 
3.6 
2.4 
3.6 

5.5 
7.7 
12.8 
17.7 
21.9 
13.3 
15.8 
14.4 
15.9 

2.1 
1.6 
4.9 
4.9 
9.1 
0.6 
5.3 
0.6 
11.8 

Middle  Atlantic  
East  North  Central.  . 
West  North  Central  . 
South  Atlantic.  .  . 

East  South  Central.. 
West  South  Central  . 
Mountain  

'6.6 
5.3 

Pacific  

37.7 

0.7 

1.7 

United  States  

New  England  
Middle  Atlantic  
East  North  Central.  .  . 
West  North  Central.  . 
South  Atlantic  
East  South  Central  .  .  . 
West  South  Central 

Admitted  during  the  year 

23.8 

0.6 

1.8 

4.0 

3.5 

10.3 

3.7 

16.3 
15.4 
25.0 
38.9 
27.0 
30.4 
9  1 

0.5 
0.7 
0.4 
0.8 

"2.2" 

1.3 
2.2 
1.2 
1.3 

'3.6 

2.5 
3.9 
3.7 
4.8 
3.4 
8.9 

3.8 
2.0 
3.6 
5.6 
3.4 
10.4 

6.4 
4.9 
12.1 

18.4 
15.7 
5.2 

1.9 
1.6 
3.9 
8.0 
5.4 
0.7 
9.1    , 
4.2 
8.2 

Mountain.  .  .        

39.4 

4.2 
4.1 

18.3 

1.4 

11.3 
21.1 

Pacific  

33.5 

APPENDIX  A 


387 


While  the  statistics  having  to  do  with  insanity  appear 
to  indicate  that  mental  disorders  are  more  prevalent  among 
the  foreign-born  than  among  the  native  population,  in  all 
fairness  to  the  immigrant,  attention  should  be  called  to 
the  fact  that  the  foreign-born  population  contains  fewer 
children,  and  therefore  must  represent  a  larger  number  of 
individuals  who  have  reached  those  ages  at  which  insanity 
more  commonly  appears.  Again,  many  borderline  cases 
of  defectiveness  have  their  latent  tendencies  developed  by 
the  stress  and  strain  of  a  new  and  strange  environment. 

TABLE    NO.    9 
COMPARISON  BETWEEN  NATIVE  AND  FOREIGN  INSANE 


.Age  group 

Native  White.  1910 

Foreign-born  White,  1910 

Total 
number 

Admitted  to 
hospitals  for 
the  insane 

Total 
number 

Admitted  to 
hospitals  for 
the  insane 

Number 

Per 
100,000 

Number 

Per 
100.000 

AH  ages  

68,386.412 

39.629 

57.9 

13.345.545 

15.523 

116.3 

Under  15  years  

24.957,149 
7,294,630 
6,556,030 
5.594,440 
4,761,561 
4,323,752 
3,476,797 
2.914.702 
2,630.258 
1.870,686 
1.441,740 
1.061.557 
693.917 
412,780 
288,400 
108.013 

256 
1.871 
3,966 
4,749 
4,841 
4.999 
4,201 
3.656 
3,197 
2,178 
1,728 
1,282 
1.009 
694 
570 
432 

1.0 
25.6 
60.5 
84.9 
101.7 
115.6 
120.8 
125.4 
121.5 
116.4 
119.9 
120.8 
145.4 
168.1 
197.6 

759.346 
673.761 
1.430,381 
1.662,696 
1,505.715 
1,408.093 
1.303.475 
1,146.360 
925.055 
693.520 
627.583 
488.397 
336,967 
208,212 
149,773 
26.211 

10 
320 
1,074 
1.568 
1.777 
1,848 
1.755 
1.605 
1,341 
982 
928 
765 
610 
407 
370 
163 

1.3 

47.5 
75.1 
94.3 
118.0 
131.2 
134.6 
140.0 
145.0 
141.6 
147.9 
156.6 
181.0 
195.5 
264.7 

15  to  19  years  

20       24 

25       29            

30       34            

35       39            

4O       44            

45       49 

50       54            

55       59            

60       64            .... 

65       69            

70       74 

75       79            

80  years  and  over  
Age  unknown  

Of  course,  insanity  statistics  respecting  our  foreign-born 
population  are,  in  general,  subject  to  the  same  interpretations 
that  have  been  applied  to  the  data  on  insanity  as  concerns 
our  population  as  a  whole. 


388 


RACE  DECADENCE 


DISTRIBUTION  OF  FEEBLE-MINDEDNESS 

The  following  table  gives,  by  geographic  divisions,  the 
number  of  feeble-minded  enumerated  in  institutions  for  this 
class  on  January  I,  1910,  and  the  number  admitted  during  the 
year,  with  the  ratio  per  100,000  population.  Similar  statistics 
are  presented  also  for  the  total  combined  number  of  feeble- 
minded in  special  institutions  and  in  almshouses. 

TABLE  NO.  IO 
DISTRIBUTION  OF  FEEBLE-MINDEDNESS 


Division 

Feeble-minded  in 
special  institutions 

Feeble-minded  in 
special  institutions 
and  in  almshouses 

Enumerated 
on  January 
1,  1910 

Admitted 
during  the 
year  1910 

Enumerated 
on  January 
1.  1910 

Admitted 
during  the 
year  1910 

United  States  

Number 

20,731 

3,825 

33,969 

8,233 

New  England  

2,012 
6.766 
5,941 
3,906 
584 
330 
19 
160 
1,013 

640 
1,152 
909 
624 
89 
135 
11 
71 
194 

3,569 
9,097 
9,808 
5,428 
2.452 
1,384 
384 
316 
1,531 

1,000 
2,122 
1.972 
1.003 
786 
588 
159 
185 
418 

Middle  Atlantic  .  .          

East  North  Central  

West  North  Central  

South  Atlantic  

East  South  Central   

West  South  Central  

Mountain  

Pacific  

United  States  

Number  per  100,000  population 

22.5 

4.2 

36.9 

9.0 

New  England     

30.7 
35.0 
32.6 
33.6 
4.8 
3.9 
0.2 
6.1 
24.2 

9.8 
6.0 
5.0 
5.4 
0.7 
1.6 
0.1 
2.7 
4.6 

54.5 
47.1 
53.7 
46.6 
20.1 
16.5 
4.4 
12.0 
36.5 

15.3 
11.0 
10.8 
8.6 
6.4 
7.0 
1.8 
7.0 
10.0 

Middle  Atlantic  

East  North  Central  

West  North  Central  

South  Atlantic    

East  South  Central  

West  South  Central  

Pacific  

It  is  evident  that  the  number  of  feeble-minded  in  differ- 
ent sections  of  the  country,  as  shown  by  statistics,  is  de- 
termined by  the  prevalent  practice  of  placing  these  defectives 
in  public  institutions,  and  not  by  the  actual  number  of 
these  individuals  in  the  population. 


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APPENDIX  B 
ECONOMIC  LOSSES  FROM  SICKNESS 

THE  annual  economic  loss  due  to  preventable  disease  and 
death  is  conservatively  estimated  at  $3,000,000,000,  and 
our  annual  fire  loss  at  about  $250,000,000.  Careful  studies 
of  sickness  suggest  that  the  average  working  family 
should  reckon  on  spending  about  4  per  cent  of  its  wages  or 
salary  on  account  of  sickness  —  directly  or  indirectly. 

The  United  States  spends  about  $7,000,000  a  year  on 
bugs  and  weeds:  how  much  on  babies?  The  government 
spends  approximately  $6,000,000  a  year  on  animal  diseases : 
how  much  on  hygiene  and  eugenics  ? 

If  we  appraise  each  life  lost  at  only  $2,000  and  each  year's 
average  earnings  for  adults  at  only  $1,000,  the  economic  gain 
to  be  obtained  from  preventing  disease,  measured  in  dollars, 
amounts  to  over  $2,000,000,000. 

RESPONSIBILITY   FOR  SICKNESS 

Three  things  are  primarily  to  blame  for  sickness  —  the 
individual,  the  community,  and  the  industry.  Each  may  be 
charged  directly  with  the  cause  of  certain  diseases  while  all 
three  combine  in  causing  and  accentuating  other  diseases. 

The  causes  for  which  the  individual  is  directly  responsible 
are  intemperance  in  the  use  of  food,  drugs,  and  alcohol,  care- 
lessness and  recklessness  in  his  daily  work  and  conduct. 

The  community's  responsibility  is  principally  on  account  of 
contagious  diseases  and  particularly  filth  diseases,  such  as 
typhoid,  tuberculosis  due  to  insanitary  conditions  and  bad 
housing,  failure  to  provide  adequately  for  child  protection  and 
care,  general  sanitation,  and  health  education. 

392 


APPENDIX  B  393 

The  responsibility  of  industry  is  principally  due  to  the 
following  causes  of  disease:  dust,  bad  illumination,  devitaliz- 
ing air,  extremes  of  temperature,  fatigue,  infections,  and 
poisons.  These  altogether  constitute  what  are  generally 
known  as  the  "  health  hazards  in  industry,"  and  from  them 
many  diseases  directly  result,  among  which  are  included  the 
so-called  "  occupational  diseases." 

LOSS   OF   WORKING  TIME  AND   WAGES 

If  2  per  cent  of  the  38,167,336  persons  gainfully  employed 
in  the  United  States  are  constantly  suffering  from  actually 
disabling  illness  and  an  additional  1.5  per  cent  are  seriously 
ill,  although  still  at  work,  we  have  a  total  of  1,335,856  em- 
ployed persons  ill  at  any  given  time. 

An  average  of  9  days  lost  from  work  each  year  by  each 
employee  may  not  seem  a  particularly  long  period,  until  we 
realize  that  the  38,000,000  employed  persons  and  the  indus- 
tries which  employ  them  are  losing  each  year  at  least  342,- 
000,000  days  because  of  illness,  at  least  half  of  which  is  pre- 
ventable. 

From  the  standpoint  of  the  employees,  these  days  of 
sickness  represent  a  money  loss  of  many  millions  of  dollars. 
The  Pennsylvania  Health  Insurance  Commission  estimates 
that  in  that  state  alone  employees  are  losing  more  than 
$39,000,000  in  wages  annually  because  of  sickness.  A  total 
loss  of  wages  almost  always  occurs  during  absence  from 
work  because  of  illness.  Only  the  skilled  worker  and  salaried 
employee  escapes  this  loss;  in  fact  the  average  wage-earner 
may  consider  himself  fortunate  if  his  place  is  reserved  until 
his  return.  In  a  study  of  500  working  women,  the  wage  was 
found  to  have  been  continued  in  just  three  instances  of  sick- 
ness. In  the  Kensington  survey,  the  wage  loss  was  reported 
in  367  cases  an  average  of  $78.53  per  case,  or  more  than  a 
month's  pay  of  a  single  worker,  according  to  the  family 


394  RACE  DECADENCE 

income  found  in  the  survey.  It  is  easy  to  see  that  the 
average  employee,  unless  he  has  other  wage-earners  in  the 
family,  or  relatives  able  to  help  him,  may  find  the  wage  loss 
from  illness  alone  an  intolerable  burden,  eating  up  his  sav- 
ings, piling  up  debts,  and  lowering  his  whole  standard  of 
living. 

The  statistics  of  the  Workmen's  Sick  and  Death  Benefit 
Society  of  New  York,  compiled  by  the  United  States  Depart- 
ment of  Labor  Statistics  for  the  state  health  insurance  com- 
missions, shows,  for  34,502  cases  of  disability,  that  16.9  per 
cent  of  the  members  are  disabled  every  year  for  more  than 
7  days,  and  23.5  per  cent  for  more  than  i  day.  The  distribu- 
tion of  cases  of  sickness  was  as  follows:  23.6  per  cent  of 
those  sick  were  sick  from  i  to  6  days;  64  per  cent  from  i 
to  4  weeks ;  19.7  per  cent  from  4  to  8  weeks ;  7  per  cent  from 
S  to  12  weeks;  6  per  cent  from  8  to  25  weeks;  and  2.7  per 
cent  from  25  weeks  to  a  year. 

The  seven  sickness  surveys  of  the  Metropolitan  Life  In- 
surance Company,  covering  637,000  persons  in  families  of 
policy  holders,  showed  that  2.08  per  cent  were  seriously  sick, 
1.9  per  cent  were  disabled,  and  of  those  who  were  sick,  14.7 
per  cent  were  sick  for  less  than  6  days ;  39  per  cent  for  less 
than  4  weeks ;  10  per  cent  for  from  i  to  2  months ;  4.8  per 
cent  for  from  2  to  3  months ;  7.8  per  cent  for  from  3  to  6 
months ;  6  per  cent  for  from  6  months  to  a  year ;  25.8  per 
cent  for  more  than  a  year;  and  5.9  per  cent  not  specified. 
This  is  a  better  view  of  long-time  disability  in  the  general 
population,  but  is  not  so  accurate  for  the  workers  as  the 
benefit  funds  analyzed  by  the  state  health  insurance  com- 
missions above  noted,  which  take  account  only  of  men  who 
were  actually  at  work. 

Similar  figures  in  the  California  health  insurance  survey  in 
1915  showed  that  10  men  out  of  1,262  suffered  one-fourth 
the  total  loss  of  working  days.  In  Philadelphia  a  study  made 


APPENDIX  B  395 

for  the  Pennsylvania  Health  Insurance  Commission  showed 
that  9  out  of  201  men  who  lost  time  accounted  for  one-third 
of  the  entire  group  loss.  Five  men  lost  an  average  of  more 
than  525  consecutive  days. 

The  benefit  fund  study  by  the  state  health  insurance  com- 
missions, which  represents  workers  only,  brings  out  the  sig- 
nificant fact  that,  while  the  cases  of  from  8  to  14  days  in 
duration  represented  34.6  per  cent  of  the  total  number,  they 
represented  only  10.7  per  cent  of  the  total  time  lost;  that 
cases  of  less  than  12  weeks'  duration  represented  90.6  per 
cent  of  the  cases  and  only  62.5  per  cent  of  the  total  loss ;  and 
that  cases  of  less  than  26  weeks'  duration  represented  96.6 
per  cent  of  all  cases  and  only  81.48  per  cent  of  the  total  loss. 
Stated  conversely,  the  persons  who  were  sick  more  than  12 
weeks  represented  only  9.31  per  cent,  yet  bore  32.56  per  cent 
o{  the  loss ;  and  persons  who  were  sick  more  than  26  weeks 
represented  only  3.4  per  cent  of  the  cases  and  bore  18.52 
per  cent  of  the  loss. 

SICKNESS  AND  ECONOMIC  DISTRESS 

Sidney  and  Beatrice  Webb  say  that,  "  In  all  countries,  at 
all  ages,  it  is  sickness  to  which  the  greatest  bulk  of  destitu- 
tion is  immediately  due."  In  the  United  States,  from  investi- 
gations made  in  various  communities,  it  would  seem  that  from 
25  to  50  per  cent  of  the  families  asking  charitable  relief  have 
been  brought  into  the  dependent  group  because  of  sickness. 
Edward  T.  Devine,  the  head  of  the  New  York  Charity  Or- 
ganization Society,  says : 

111  health  is  perhaps  the  most  constant  of  the  attendants  of 
poverty.  It  has  been  customary  to  say  that  25  per  cent  of  the 
distress  known  to  charitable  societies  is  caused  by  sickness.  An 
inquiry  into  the  physical  condition  of  the  members  of  the  families 
that  ask  for  aid,  without  for  the  moment  taking  any  other  complica- 
tion into  account,  clearly  indicates  that  whether  it  be  for  the  first 
cause  or  merely  a  complication  from  the  effect  of  other  causes, 


396  RACE  DECADENCE 

physical  disability  is  at  any  rate  a  very  serious  disabling  condition 
at  the  time  of  application  in  thiee-fourths —  not  one-fourth  —  of  all 
the  families  that  come  under  the  care  of  the  Charity  Organization 
Society,  who  are  probably  in  this  respect  in  no  degree  exceotional 
among  families  in  need  of  charitable  aid. 

As  the  result  of  an  investigation  covering  forty-three 
cities  and  over  30,000  charity  cases  the  United  States  Immi- 
gration Commission  found  that  illness  of  the  bread-winner 
or  other  member  of  the  family  was  a  factor  in  38.3  per  cent 
of  the  cases  of  those  seeking  aid.  In  New  York  City  "  sick- 
ness or  deformity  "  were  present  in  two-thirds  of  the  3,000 
families  assisted  by  the  Charity  Organization  Society  in  the 
first  five  months  of  1916 ;  in  Chicago  sickness  is  reported  as 
the  primary  factor  in  25  per  cent  of  the  cases  cared  for  in 
1917  by  the  United  Charities  Organization,  and  as  a  con- 
tributory factor  in  45  per  cent  of  the  other  cases;  in  San 
Francisco  and  Los  Angeles  sickness  was  the  primary  cause 
of  destitution  in  50  per  cent  of  over  5,000  charitable  cases. 

Suppose  we  allow  that  the  adult  wage-earner  loses  en  an 
average  but  2  days  annually  as  the  result  of  "  colds."  Let 
us  estimate  the  daily  wage  of  such  men  at  $4.  It  is  certain 
that  large  numbers  of  people  who  are  kept  from  their  work 
by  "  colds  "  sustain  a  loss  equal  to  many  times  this  sum. 
Now,  estimating  that  we  have,  say  15,000,000  of  wage-earners 
who  are  thus  afflicted  each  year,  it  will  at  once  appear  that 
we  have  a  direct  economic  loss  of  $120,000,000. 

Further  inquiries  conducted  by  the  author  tend  to  show 
that  the  average  individual  spends  from  $2  to  $4  on  either 
patent  medicine,  "  cold  cures,"  or  physicians'  fees  each  year 
in  the  treatment  of  this  so-called  minor  affliction.  A  very 
moderate  estimate  for  what  is  spent  directly  on  the  treatment 
of  colds  each  year  would  be  about  $40,000,000,  and  this 
hardly  makes  allowance  for  the  money  spent  in  treating  colds 
in  the  case  of  infants,  children,  and  other  non-wage-earners, 


APPENDIX  B  397 

all  of  whom  suffer  equally  from  this  complaint.  Thus,  by 
the  most  moderate  estimates  based  upon  fairly  reliable  data, 
we  have  a  direct  annual  loss  to  the  American  people  of 
$160,000,000  as  the  result  of  colds.  If  the  real  facts  were 
known  and  we  were  in  possession  of  absolutely  reliable  statis- 
tics, we  believe  this  sum  would  mount  up  to  more  than 
$200,000,000.  It  certainly  would  if  influenza  and  its  after 
disability  and  treatment  were  taken  into  account. 

THE  BOSTON  STATISTICS 

In  Boston,  407  families  were  studied,  averaging  a  little 
more  than  5  persons  per  family.  The  average  expenditure 
for  sickness  was  $49.76,  or  about  3.5  per  cent  of  the  average 
annual  income.  Here,  again,  the  expenditure  varied  with 
income.  In  the  group  under  $900  there  was  an  average  out- 
lay, of  $23.18.  In  the  group  over  $2,500  the  average  expen- 
diture was  $67.42. 

It  may  be  fair  to  assume,  however,  from  the  more  recent 
investigations,  that  the  average  expenditure  of  a  family  in 
the  $1,000  income  group  may  vary  from  3  per  cent  to  5  per 
cent  of  the  total  income. 

Probably  some  light  may  be  thrown  upon  the  subject  if 
we  study  it  from  a  different  angle.  In  recent  sickness  sur- 
veys made  by  the  Metropolitan  Life  Insurance  Company,  it 
was  shown  that  the  average  individual  is  sick  7  days  per 
annum. 

If  we  take  as  our  unit  the  average  family  of  5  persons, 
consisting  of  father  and  mother  and  3  children,  and  use  the 
above  average  of  7  days'  illness  per  member,  we  may  assume 
that  in  such  an  average  family  there  are  35  days  of  illness 
per  annum.  On  the  assumption  that  half  of  the  incapacitated 
are  chronic  invalids  who  do  not  require  the  daily  visit  of  the 
physician,  it  is  probably  not  an  exaggeration  to  assume  that 
the  35  days  of  illness  would  require  17  visits.  The  cost  of  a 


398  RACE  DECADENCE 

physician's  visit  in  the  home  has  increased  along  with  the 
other  necessities  of  life.  It  is  doubtful  whether  in  the  large 
cities  physicians'  services  can  be  obtained  today  under  $2  per 
visit.  This  would  mean  $35  per  annum  for  physicians'  serv- 
ices alone.  It  is  true,  of  course,  that  many  of  these  patients 
are  in  hospitals  and  institutions.  The  cost  of  this  hospital 
service  would  probably  run  as  high  as  the  cost  of  the  physi- 
cians' visit  to  the  home.  It  is  quite  unlikely  that  the  average 
modern  hospital  can  give  service  under  $2  or  more  per  diem. 
It  is  immaterial,  of  course,  whether  such  service  is  given  free 
or  is  paid  for.  It  must  be  included  in  the  amount  which 
should  be  provided  in  the  family  budget  for  self-sustaining 
families. 

In  this  calculation  no  provision  has  been  made  for  dental 
care  of  the  members  of  the  family.  In  the  opinion  of  com- 
petent oral  hygienists,  prophylactic  care  should  be  given  to 
the  teeth  at  least  twice  a  year.  Assuming  that  it  were  done 
only  yearly,  the  expense  for  this  would  be  at  the  lowest  pos- 
sible estimate  approximately  $10  per  annum.  Nursing  care 
given  by  a  visiting  nurse  would  vary  from  $10  to  $20  per 
annum.  It  is  difficult  to  make  any  estimate  of  the  cost  of 
eye-glasses  and  the  care  of  the  eyes  generally  but  it  would 
be  safe  to  assume  an  expenditure  of  $10  per  annum. 

It  is  difficult  to  see  how  the  average  family  of  wage-earners 
which  does  not  avail  itself  of  medical  charity  can  get  on  with 
less  than  about  $75  per  year  as  its  minimum  expenditure  for 
combined  dental  and  medical  care. 

ECONOMIC   LOSS  IN   NORTH    CAROLINA 

The  white  male  population  of  North  Carolina,  at  ages  15 
and  over,  is  estimated  at  492,585,  for  the  year  1916.  On  the 
hypothesis  that  the  sickness  rates  of  the  survey  remain  con- 
stant throughout  the  year,  we  may  assume  that,  at  any  time, 
at  least  12,512  white  males  are  sick.  This  means  approxi- 


APPENDIX  B 


399 


irately  3,753,600  days  of  disability  from  work  for  this  group 
of  the  population  using  300  working  days  per  year  for  each 
individual  as  a  basis  of  calculation.  Similarly  we  may  assume 
that  there  are  16,835  wm'te  females  constantly  sick  through- 
out the  year  for  a  total  period  of  5,050,500  days  of  disability 
from  pursuit  of  the  daily  occupations  of  life.  Among  colored 
males  our  estimate  is  1,561,200  days  of  disability  for  5,204 
persons  constantly  sick,  and  for  colored  females  a  total  period 
of  disability  of  2,607,900  days  for  8,693  persons.  No  mone- 
tary estimates  of  disability  need  be  computed  to  emphasize 
this  enormous  loss  of  working  time  in  the  productive  years  of 
life.  Whatever  the  financial  estimate  based  upon  wage  loss, 
we  have  still  to  consider  the  cost  of  medical  attendance, 
nursing  care  and  drugs,  and  the  far-reaching  effects  of  sick- 
ness in  impairing  the  living  and  working  efficiency  of  the 
famjlies  affected  by  the  disability  of  one  or  more  members. 

THE  PITTSBURGH  SURVEY 

It  is  reasonable  to  assume,  for  purposes  of  computing  the 
estimated  loss  to  industry  from  sickness  in  Pittsburgh,  that 
the  sickness  rates  observed  during  the  month  of  March 
operate  constantly  throughout  the  year.  This  assumption 
will  produce  fairly  conservative  figures.  Thus,  among  an 
estimated  number  of  215,720  males  aged  15  years  and  over 
in  Pittsburgh,  at  a  rate  of  20.2  persons  per  1,000  constantly 
sick  and  unable  to  work,  there  would  be  4,358  adult  males 
constantly  ill  and  unable  to  work  on  this  average  through- 
out the  year.  Assuming  300  days  as  the  average  work- 
ing year,  we  have  a  loss  of  1,307,400  working  days  per 
year.  The  sickness-rate  involving  disability  for  work, 
applied  to  202,238  females  15  years  of  age  and  over,  would 
produce  the  figure  of  3,701  females  constantly  sick  through- 
out the  year.  This  implies  a  loss  of  1,110,300  working  days 
per  year.  On  a  basis  of  the  total  number  of  males  15  years 


400  RACE  DECADENCE 

of  age  and  over  exposed  to  disabling  sickness  in  Pittsburgh, 
there  would  be  an  average  loss  of  6.1  days  per  year  per 
person;  for  females  15  years  of  age  and  over,  we  may  safely 
assume  an  average  loss  of  working  capacity  per  female 
exposed  of  5.5  days  per  year. 

CALIFORNIA    DATA 

The  Industrial  Welfare  Commission  of  California  pub- 
lished in  the  year  1917  the  records  of  one  year's  expenditures 
of  600  working  women  in  San  Francisco  and  Los  Angeles. 
The  records  were  classified  according  to  their  earning  ca- 
pacity and  occupation.  The  amount  spent  by  each  group 
for  medical  services  was  approximately  4  per  cent  of  the 
income. 

Similarly,  in  a  group  of  251  laundresses,  the  expenditure 
for  medical  and  dental  care  amounted  to  5.1  per  cent  of  their 
aggregate  earnings.  The  bulk  of  the  cases  in  this  group  had 
an  actual  income  of  from  $350  to  $500  per  annum.  The 
average  annual  expenditure  for  medical  and  dental  care  was 
approximately  from  $18  to  $25  per  annum. 

The  Commission  also  presented  the  records  of  264 
waitresses.  In  this  group,  3.9  per  cent  of  the  aggregate 
earnings  was  expended  on  medical  and  dental  care  each 
year. 

One  of  the  studies  for  the  year  ending  March  31,  1916, 
made  among  508  families  in  Cleveland,  Lorain,  and  Toledo 
showed  an  average  expenditure  of  $41.79  for  medical  care 
and  $8.59  for  dental  care.  Of  the  families  in  this  group 
20  per  cent  spent  less  than  $10  for  medical  care  and  more 
than  17  per  cent  between  $10  and  $19.  At  least  two- 
thirds  of  the  entire  group  spent  less  than  $40  per  year 
for  medical  care.  In  Columbus,  Ohio,  a  similar  study  of 
211  families  showed  that  $42.41  was  spent  for  medical 
care  per  family  and  $6  for  services  of  the  dentist. 


APPENDIX  B  401 

ECONOMIC    VALUE  OF   POSTPONING   DEATH 

By  many  authorities  and  by  numerous  methods  efforts 
have  been  made  to  arrive  at  an  estimate  of  the  value  —  in 
dollars  —  of  increased  health  and  efficiency  and  to  esti- 
mate the  economic  value  of  lives  saved  as  a  result  of  bet- 
ter sanitary  surroundings  and  improved  hygienic  living 
conditions. 

The  economic  value  of  a  given  life  is  arrived  at  by 
estimating  the  worth  of  a  laborer's  output  at  various  times 
during  his  life  by  discounting  his  chances  of  future  earn- 
ings and  then  subtracting  the  cost  of  his  maintenance.  In 
this  way  we  make  a  rough  estimate  of  the  economic  saving 
which  may  be  effected  by  improving  the  health  and  in- 
creasing the  length  of  life  of  the  American  wage-earner. 

It  is  generally  assumed  that  about  three-fourths  of  those 
oft  working  age  are  actually  wage-earners  or  the  equiva- 
lent —  housekeepers.  The  money  value  of  an  individual 
thus  reckoned  starts  out  at  about  $150  for  the  first  year 
and  gradually  rises  to  about  $7,000  at  the  age  of  30,  after 
which  there  is  a  steady  decline  until  it  reaches  zero  at  the 
higher  and  inactive  ages.  This  estimate  would  about  as- 
sume $1,200  a  year  to  be  the  average  earnings  of  middle 
life.  Applying  this  conjecture  to  the  present  American 
population  we  find  that  the  estimated  or  average  value  of 
a  person  to  be  in  the  neighborhood  of  $5,000. 

On  this  basis,  the  value  of  the  average  person  who  is 
now  sacrificed  by  preventable  disease  is  reckoned  at  about 
$3,000 —  owing  to  the  fact  that  the  age  of  those  who  die 
is  considerably  greater  than  the  age  of  the  living.  Applying 
this  estimated  life-value  of  $5,000  to  a  supposed  population 
of  —  Say  100,000,000  —  and  we  find  that  the  economic  value 
of  the  people  of  this  country  to  be  $500,000,000,000.  Now, 
since  the  number  of  preventable  deaths  has  been  estimated 


402  RACE  DECADENCE 

at  almost  1,000,000  a  year  (at  least  500,000  by  the  most 
conservative)  it  would  appear  that  our  annual  preventive 
death-waste  runs  anywhere  from  $1,500,000,000  up  to 
$3,000,000,000. 

ECONOMIC  VALUE  OF  INCREASED  HEALTH 

In  the  preceding  chapters  estimates  were  noted  which 
indicate  that  there  are  from  3,000,000  to  5,000,000  per- 
sons sick  all  the  time  in  the  United  States.  About  one- 
third  of  this  number  of  disabled  persons  are  in  the  working 
period  of  life  and  of  this  number  of  persons  of  working 
age  fully  75  per  cent  are  actual  wage-earners.  This  would 
indicate  that  there  are  at  least  1,000,000  bona  fide  wage- 
earners  sick  all  the  time.  If  we  estimate  the  average  eco- 
nomic value  of  these  persons  at  the  figure  already  noted  — 
$1,200  per  year  —  it  would  give  us  an  aggregate  annual 
economic  loss  from  illness  equal  to  $1,200,000,000. 

We  should  add  to  this  annual  sickness  money  loss  of 
over  $1,000,000,000  another  $1,000,000,000  for  medicine, 
medical  attention,  nursing,  etc.,  making  the  combined  cost  of 
our  national  illness  considerably  over  $2,000,000,000  a  year. 
And  it  is  a  conservative  estimate  to  suppose  that  at  least 
one-half  of  this  illness  is  preventable  —  making  the  net 
preventable  sickness  of  the  nation  cost  us  a  little  over 
$1,000,000,000  a  year. 

Now,  if  we  add  the  preventable  loss  from  death  —  say 
at  $2,000,000,000  —  to  this  economic  loss  from  preventable 
illness  of  at  least  $1,000,000,000  it  gives  us  the  economic 
grand  total  of  $3,000,000,000  as  the  very  lowest  estimate 
of  our  annual  economic  loss  from  preventable  diseases 
and  premature  —  and  preventable  —  deaths  in  the  United 
States.  It  is  the  author's  opinion  that  this  figure  should 
be  more  nearly  $5,000,000,000,  but  when  we  are  dealing  with 
figures  that  are  probably  based  on  conjecture,  it  behooves 


APPENDIX  B  403 

us  to  be  cautious  and  conservative  in  reaching  our  final 
conclusions. 

Truly  our  greatest  national  resource  is  human  life,  and  our 
supreme  duty  its  prolongation.  Our  greatest  national  asset 
is  health,  and  our  greatest  national  business  its  promotion 
and  betterment. 


APPENDIX  C 
SPECIAL  DIET  LIST  FOR  AUTO-INTOXICATION 

THIS  diet  is  arranged  with  a  view  of  preventing  intes- 
tinal fermentation  and  the  undue  increase  of  acidity  in 
the    blood-stream,    and    is    indicated    in    acidemia    (acido- 
sis),  auto-intoxication,  intestinal  toxemia,  so-called  rheuma- 
tism, neuritis,  colitis  (catarrh  of  the  bowel),  flatulency,  etc. 
/.  Fruits. —  Ripe    apples,    ripe   bananas,    pears,    peaches, 
melons,  figs,  dates,  raisins,  prunes,  ripe  olives,  grapefruit, 
oranges,  lemons,  together  with  grape  juice,  blackberry  juice, 
raspberry  juice,  and  apple  juice. 

2.  Vegetables. —  Baked  potatoes,  tomatoes,  raw  cabbage, 
celery,  and  vegetable  soups. 

3.  Cereals. —  Hard  breads,  dextrinized  cereals  —  such  as 
Zwieback,  toast,  toasted  flaked  cereals,  popped  corn,  rice 
biscuits,  browned  rice,  gluten  mush,  macaroni,  and  oatmeal. 

4.  Dairy    products. —  Milk,    cream,    buttermilk,   cottage 
cheese,  butter,  yolks  of  eggs,  and  malted  milk. 

5.  Nuts. —  Blanched    almonds,    Brazil    nuts,    cocoanuts, 
roasted  chestnuts,  filberts,  and  pecans. 

6.  Foods  to  avoid. —  Meats  of  all  sorts,  fish,  fowl,  oysters, 
shell  fish,  lobsters,  crabs,  whites  of  eggs,  old  cheese,  rich 
and  highly  seasoned  foods,  meat  gravies,  pastries,  tea,  cof- 
fee, and  condiments.     Eat  sparingly  of  the  legumes. 

In  dieting  for  auto-intoxication  it  should  be  remembered 
that  frequent  bowel  movements  are  desirable.  Go  to  stool 
at  least  twice  a  day.  Do  not  take  laxatives  or  cathartics 
unless  prescribed  by  your  physician.  Mineral  oil  and  bran 
are  not  cathartics. 

404 


APPENDIX  C  405 

Eat  more  largely  of  those  foods  which  assist  in  decreas- 
ing the  amount  of  acid  in  the  blood-stream  —  see  compara- 
tive list  of  acidifying  and  alkalinizing  foods  (p.  172). 

For  the  home  treatment  of  constipation  we  place  the 
following  instructions  in  the  hands  of  our  patients : 

SPECIAL  DIET  LIST LAXATIVE  FOODS 

(ANTI-CONSTIPATION  DIET) 

This  list  of  foods  is  laxative  in  its  action  and  is  indicated 
in  all  cases  of  chronic  constipation,  "  biliousness,"  and  slug- 
gish action  of  the  bowels. 

1.  Sugars. —  All  forms  of  sugars,  especially  fruit  sugar, 
marmalade,  molasses,  honey,  syrup,  and  malt.    All  the  con- 
centrated fruit  juices.     Sweet  fruits,  such  as  figs,  dates, 
raisins,  prunes,  fruit  jellies,  etc. 

2.  Sour  fruits. —  All  sour  fruits  and  fruit  acids,  such  as 
apples,  grapes,  peaches,  plums,  tomatoes,  grapefruit,  cur- 
rants,  gooseberries,    melons,    and   all   berries   with    seeds. 
Fruit   juices,   especially   from   sour    fruits  —  grape   juice, 
apple  juice,  lemonade,  etc. 

5.  Foods  rich  in  fats. —  Butter,  cream,  eggs,  eggnog,  ripe 
olives,  nuts  —  especially  pecans,  Brazil  nuts  and  pine  nuts ; 
also  olive  oil  and  bacon. 

4.  Foods   rich   in   cellulose. —  Wheat    flakes,    asparagus, 
cauliflower,  spinach,  sweet  potatoes,  green  corn  and  pop- 
corn, graham  flour  preparations  and  oatmeal  foods,  whole 
wheat  preparations,  bran  bread,  apples,  blackberries,  cher- 
ries, cranberries,  melons,  oranges,  peaches,  pineapples,  plums, 
whortleberries,  raw  cabbage,  celery,  greens,  lettuce,  onions, 
parsnips,  turnips,  oyster  plant,  lima  beans,  and  peanuts. 

5.  Miscellaneous     foods. —  Buttermilk,     koumiss,     meat 
broths,  vegetable  soups,  cereals  cooked  with  one-third  bran, 
gingerbread,  fig  puddings,  gelatine,  and  agar-agar. 

6.  Avoid. —  Tea,  coffee  (unless  very  weak),  cocoa,  choco- 


406  RACE  DECADENCE 

late,  alcohol,  much  lean  meat,  rice,  tapioca,  farina,  cheese, 
most  nuts,  sweet  milk,  eggs,  salted  meats,  fried  foods  and 
rich  deserts,  puddings,  and  pastries. 

7.  Remember. —  That  a  glass  of  cold  water  taken  the 
first  thing  on  getting  up  in  the  morning,  and  some  fresh 
fruit  on  retiring  is  very  helpful  in  many  cases.  Also  re- 
member that  you  can  take  one  to  three  tablespoonfuls  of 
mineral  oil  once  or  twice  a  day  for  considerable  periods 
of  time  without  doing  any  harm  in  the  treatment  of  con- 
stipation. 

The  successful  treatment  of  chronic  constipation  requires, 
in  addition  to  the  diet,  that  the  patient  should  carefully 
carry  out  these  general  rules,  which  are  herewith  pre- 
sented, and,  in  addition  any  and  all  special  instructions  given 
by  the  physician.  Do  not  take  any  laxatives  (except  mineral 
oil  when  ordered)  unless  they  have  been  specially  prescribed 
for  you. 

THE    HOME    TREATMENT    OF    CONSTIPATION 

/.  On  rising  in  the  morning. —  Remove  the  Moist  Ab- 
dominal Bandage ;  drink  two-thirds  of  a  glass  of  cold  water ; 
and  spend  15  to  20  minutes  as  instructed  by  the  physical 
director,  in  the  following  exercises,  before  dressing:  ab- 
dominal lifting  with  deep  breathing,  auto-massage,  leg  rais- 
ing, trunk  twisting,  trunk  bending  —  forward  and  to  sides, 
lying  down  for  the  trunk  raising,  and  sitting  for  the  trunk 
circumduction.  Immediately  following  these  exercises,  go 
to  stool.  Have  feet  raised  8  or  10  inches,  so  as  to  simulate 
the  squatting  position. 

2.  Breakfast. —  Should  include  bran  or  bran  bread,  and 
two  or  three  of  the  following  foods:  apples  with  skins, 
grapefruit,  cranberries  with  skins  (but  little  sugar),  and 
figs.  Immediately  after  breakfast  walk  15  minutes  in  the 
open  air,  practicing  deep  abdominal  breathing.  If  the  results 


APPENDIX  C  407 

at  stool  before  breakfast  were  not  satisfactory,  vaseline  rec- 
tum and  go  to  stool  again. 

5.  Lunch  and  dinner. —  Lunch  should  consist  of  fruit  only, 
while  dinner  should  include  bran  bread  and  two  of  the  fol- 
lowing foods :  spinach,  celery,  carrots,  parsnips,  squash,  and 
cabbage. 

4.  Before  retiring. —  Walk  in  the  open  air  for  15  minutes, 
after  undressing  exercise  same  as  morning;  and  on  retiring 
apply  the  Moist  Abdominal  Bandage  as  directed  below. 

5.  Directions  for  applying  Moist  Abdominal  Bandage. — 
Spread  out  the  flannel  bandage  and  over  it  place  the  mackin- 
tosh.   Wring  dry  the  cotton  strip  from  cold  water,  and  spread 
it  over  the  mackintosh.    Wrap  all  three  layers,  the  wet  cloth 
next  the  skin,  closely  about  the  body,  so  as  to  prevent  the  air 
from  getting  under  it.    Be  sure  that  the  feet  are  warm  while 
adjusting  the  bandage.    In  the  morning  remove  the  bandage, 
and  rub  the  skin  briskly  with  a  Turkish  towel  dipped  in  cold 
water,  until  the  skin  is  pink  and  dry.    The  cotton  strip  should 
be  boiled  every  other  day  to  avoid  skin  eruptions. 

6.  Recipe  for  bran  bread. —  Two  eggs,  beaten  separately ; 
Y$  cup  of  molasses,  plus  i  round  teaspoonful  soda;  i  cup  of 
sour  cream;   i  cup  of  Sultana  seedless  raisins;   i  cup  of 
wheat  flour,  plus  i  heaping  teaspoonful  baking  powder;  2 
cups  of  bran;  stir  well  and  bake  i  hour. 

"REST  CURE"  DIET 
(THE  MILK  AND  FRUIT-JUICE  REGIME) 

The  "  Rest  Cure-"  diet  or  the  "  Milk  and  Fruit  Regime  " 
should  not  be  confused  with  the  old  so-called  milk  diet.  This 
new  "  milk  and  fruit  diet  "  is  used  in  connection  with  the 
"  Rest  Cure  "  —  the  patient  remaining  in  bed  and  "  feeding  " 
according  to  the  schedule.  This  diet  is  also  of  great  value  in 
those  cases  where  it  is  desired  to  bring  about  a  change  in  the 
"  intestinal  flora  "  —  where  it  is  desirable  to  starve  out  and 


408  RACE  DECADENCE 

drive  out  the  more  vicious  and  harmful  bacteria  so  commonly 
inhabiting  the  bowel  tract.  As  a  general  rule  the  following 
schedule  is  advised : 

1.  First  two  days. —  For  the  first  two  days  take  only  orange 
juice  —  two  dozen  a  day  —  with  hot  water  in  abundance. 

2.  Third  day. —  On  the  third  day  give  whole  milk  and  fruit 
juice,  as  follows:  one  glass  of  whole  milk  sipped  through  a 
straw  every  hour.    With  each  glass  of  milk  the  juice  of  one- 
half  lemon  and  the  juice  of  one  whole  orange    (without 
sugar)  should  also  be  sipped  through  a  straw  —  taking  three 
sips  of  milk,  one  sip  of  fruit  juice,  etc. 

3.  Fourth  day  and  after. —  On  the  fourth  day  carry  out 
the  same  program,  only  make  the  interval  forty-five  minutes 
instead  of  one  hour.    To  the  four  or  five  quarts  of  whole 
milk  to  be  taken  each  day,  add  cream,  gradually,  in  increasing 
quantities  until  the  mixture  contains  from  one-fourth  to  one- 
third  cream.     In  addition  to  this  milk  and  cream  mixture, 
the  lemon  and  orange  juice  is  continued  just  as  directed  for 
the  third  day's  feeding.    If  the  bowels  are  too  loose,  decrease 
the  amount  of  lemon  juice. 

4.  Feeding  intervals. —  As  a  rule  it  is  best  to  start  the 
"  feedings  "  at  7:30  A.  M.  and  "  feed  "  every  forty-five  min- 
utes to  one  hour  until  7:30  P.  M. 

5.  Quantity  of  milk. —  A  small  amount  of  milk  is  constipat- 
ing, but  a  large  amount  is  laxative.    In  this  regime  it  is  neces- 
sary to  take  four  to  six  quarts  of  milk  every  twenty-four 
hours  and  fruit  juice  as  prescribed. 

6.  Vegetables. —  Once  a  day,  say  at  2  :oo  P.  M.,  lettuce  or 
celery  may  be  added  or  given  in  the  place  of  the  fruit  juices 
for  those  who  prefer  it. 

7.  In  case  of  trouble. —  If  the  schedule  in  any  way  dis- 
agrees notify  your  doctor.    Nausea  is  often  overcome  in  the 
first  few  days  of  the  "  Cure  "  by  increasing  the  milk. 


INDEX 


INDEX 


Abnormal     physical     conditions, 

leading    causes   of,   318 
Abortion,   120 

Accidents,  caused  by  automo- 
biles, 38;  industrial,  309;  ma- 
chinery, deaths  caused  by,  38; 
mine,  deaths  caused  by,  38; 
number  of  in  mines,  63 ;  rail- 
road, deaths  caused  by,  63; 
street-car,  deaths  caused  by, 
38;  various,  number  of  deaths 
caused  by,  63 

Age,   influence  of,   on   mortality 

statistics,     34;      medium,     at 

Beath  of  American  people,  41 

Air,  impure,  effect  on  lung  cells, 

138 

Alcohol,  20;   amount  consumed, 

42;  and  cell  destruction,  139; 

effect  on  blood-pressure,  177; 

effect  on  kidneys,  149 

American   citizenship,  and  race, 

8 
Americanitis,     and     overeating, 

157 

Americanization    problems,    4 
Amyloid    degeneration,    137 
Aneurism,  deaths  caused  by,  38 
Anti-constipation    diet,    405 
Anti-tuberculosis    societies,    105 
Aortic  regurgitation,  146 
Apoplexy,  and  high  blood-pres- 
sure,   147;   deaths   caused   by, 
38 ;  "  stroke  "  of,  143 
Arches,    of    feet,    falling,    42 
Army,   military   rejects  previous 

to  World  War,   15 
"Aristocracy  of  the   unfit,"  the, 

329 
Art  of  eating,  the,  186 


Arteries,  function  of,  143;  hard- 
ening of,  144;  hardening  of, 
deaths  caused  by,  38 

Arterial  degeneration  and  vene- 
real diseases,  156;  disorders, 
deaths  caused  by,  38 

Arteriosclerosis,  and  blood- 
pressure,  174;  and  high  blood- 
pressure,  147;  defined,  144 

Arthritis,  gonorrheal,  116 

Asiatic  cholera,  and  the  army, 
79 

Asphyxiation,  deaths  caused  by, 
38 

Auto-intoxication,  and  blood- 
pressure,  158;  and  digestion, 
42;  defined,  158-159;  special 
diet  list  for,  404 

Average  length  of  life,  34;  and 
insurance  companies,  41 ; 
methods  of  figuring,  40;  of  in- 
fant, 40;  of  the  aged,  40 

Babies  born  in  almshouses  in 
1910,  classified  according  to 
whether  father  was  in  the  in- 
stitution or  not,  and  as  legit- 
imate or  illegitimate,  by  di- 
visions —  Table  No.  13,  391 

Bacilla,  tubercle,  and  milk,   105 

Backward  child,  and  marriage, 
277;  the,  272;  individual,  the, 
299 

"  Backwardness"  and  "  dullness," 
256 

Backwardness,  and  eyestrain, 
272;  and  mental  subnormality, 
276 ;  and  "  middle-grade  "  mo- 
rons, 300 


411 


412 


INDEX 


Bailey,  cited  on  mental  defects, 

239 

Baldness,  28 

Ball  and  Thomas,  cited  on  pros- 
stitution,  120 

Bath,  effect  on  blood-pressure, 
cold,  167 ;  neutral  or  tepid,  167 ; 
sun,  167 

Bathing,  189 

Barr,  on  mental  defectives,  321 

Binet-Simon,  scale,  302;  test, 
276,  287,  299 

Biologic  aspects  of  eugenics,  360 

Biologist's  attitude,  the,  toward 
defectives,  333 

Birth-rate,  decline  of,  32;  in 
civilized  countries,  32;  in  de- 
scendants of  original  colonies, 

34 

Births,    illegitimate,   3°4 
Black  plague,  the,  no;  how  to 

fight,  126 

Blind,  in  institutions,  330 
Blood,  and  foods  which  tend  to 
acidify,  172;  to  alkalinize,  172 
Blood-pressure,  and  alcohol,  177; 
and  arteriosclerosis,  174;  and 
auto-intoxication,  158;  and 
constipation,  159;  and  meat- 
eating,  157;  and  morphine,  177; 
and  the  mental  attitude,  160- 
161 ;  and  the  milk  diet,  173 ;  ef- 
fect of  coffee  on,  156;  of  neu- 
tral bath,  167;  of  cold  bath, 
167 ;  of  sun  bath,  167 ;  of  sleep 
and  rest,  167;  of  tea,  156;  ef- 
fect on  heart  and  blood  ves- 
sels, 142;  harmful  methods  of 
lowering,  177;  high,  19,  146; 
high,  and  Bright's  disease,  147 ; 
high,  and  coffee,  156;  high,  and 
heart  failure,  147;  high,  and 
mental  diseases,  147 ;  high,  and 
apoplexy,  147;  high,  and  arte- 
riosclerosis, 147 ;  high,  and  tea, 
156;  high,  and  tobacco,  154; 
high-pressure  states,  176;  in 
relation  to  age,  174;  low-pres- 
sure states,  176;  mean,  175; 
normal,  173,  174 
Blood  test  for  syphilis,  113 


Blood  vessels,  bursting  of,  143; 
defined,  143 

Borderland  defectives,  316 

Boston,  sickness  statistics,  397; 
sickness  survey  of,  56 

Bovine  tuberculosis,  105 

Boys'  Court,  and  crime,  295 

Breathing,  deep,  183 

Bright's  disease,   148;  and  high 
blood-pressure,    147 ;    chronic, 
150;     increase    of    death-rate ' 
since  1900,  caused  by,  42 ;  num- 
ber of  deaths  caused  by,  37 

Bromids,  headache  powders,  etc., 
178 

Caffeine  of  coffee,  effect  on 
blood-pressure,  156 

California,  commission  survey, 
51 ;  survey  of  sickness  and  eco- 
nomic loss  to  wage-earner,  400 

Cancer,  among  men,  92;  among 
six  leading  causes  of  death, 
93;  among  women,  92;  and 
hemorrhoids,  93 ;  and  life  in- 
surance companies,  98;  and  ra- 
dium, 98, 99 ;  and  X-ray,  98, 99 ; 
annual  number  of  deaths 
caused  by,  62;  cause  of,  99; 
"  cures,"  frauds,  and  swindles, 
97 ;  death-rate  doubled  in  forty 
years,  95 ;  death-rate  in  Chica- 
go, 95 ;  death-rate  in  the  U.  S., 
95 ;  deaths,  prevention  of,  96 ; 
forms  of,  93 ;  more  dangerous 
to  women  than  to  men,  97 ;  in- 
crease of  in  Boston,  in  thirty 
years,  93 ;  increase  of  in  the  U. 
S.,  92;  not  contagious,  96;  not 
hereditary,  98;  number  of 
deaths  caused  by,  38;  of  bow- 
els, deaths  caused  by,  93 ;  of 
breast,  97;  of  breast,  deaths 
caused  by,  93;  female  genera- 
tive organs,  deaths  caused  by, 
93;  of  generative  organs,  97; 
of  mouth,  deaths  caused  by, 
93;  of  stomach  and  liver, 
deaths  caused  by,  93;  preva- 
lence of,  93 


INDEX 


413 


Causes  of  death  in  the  registra- 
tion area  (1917) — Table  No. 
2,  377-378 

Cell,  poisoning  and  tobacco,  139; 
degeneration,  137;  poisons,  138; 

Cells,  and  alcohol,  139;  and 
chemical  poisoning,  136;  and 
condiments,  138 ;  and  metabolic 
poisons,  138;  effect  of  impure 
water  on,  138;  lung,  impure 
air,  effect  on,  138 

Centenarians,  lessening  number 
of,  40;  living,  66-67 

Chancre,  soft,  definition  of,  119 

Chicago  Morals  Court,  and  pros- 
stitution,  253 

Chicago  Vice  Commission,  quoted 
on  prostitution,  120-121 

Children,  and  eyestrain,  272;  and 
tuberculosis,  104 ;  backward, 
272;  born  of  pauper  mothers, 
308;  physical  defects  in,  274 

Chorea,  or  St.  Vitus'  dance,  206, 
-325 ;  Huntington's,  317 

Chronic  diseases,  advice  for,  173; 
infections,  160 

Cigarette  smoking,  and  stunting 
of  growth,  139 

Clothing  healthful,  185 

Coffee,  amount  consumed  in  the 
U.  S.  156;  and  high  blood- 
pressure,  156;  increased  con- 
sumption of,  42 

Colds,  and  the  wage-earner,  396; 
neglect  of,  62 

Collies,  cited  on  syphilis,  123 

Committee  of  Sanitary  and  Mor- 
al Prophylaxis  (Baltimore), 
report  of,  122 

Committee  of  Seven  (New 
York),  report  of,  on  venereal 
infection  of  women,  122 

Comparison  between  native  and 
foreign  insane  —  Table  No.  9, 

387 

"Complement  fixation  test,"  118 
Condiments,  effect  on  "  old-age  " 
diseases,  156,  157;  and  cell  de- 
struction, 138 
Congenital  syphilis,  ill 


Constipation,  and  blood-pressure, 
159;  home  treatment  of,  406 

Constitutional  inferiority,  257 

Consumptives,  number  of  in  the 
U.  S.,  60 

Continence,  compatible  with 
health,  127 

Crime,  a  survey  of,  288;  and 
feeble-mindedness,  280,  292 ; 
and  environment,  312,  282; 
and  punishment,  312;  and  race, 
285 ;  findings  of  Boys'  Court 
in,  295 ;  influences  predispos- 
ing to,  281,  283;  physical  side 
of,  293 

Criminal  heredity,  290 

Criminals,  and  idiocy,  236;  as  a 
class,  289;  in  institutions,  331 

Dana,  cited  on  insanity,  217 
Davenport,  cited  on  mental   de- 
fectives,   paupers,    and    crim- 
inals, 60,  332 

Deaf,  in  institutions,  330 
Death,  report  of  the  Census  Bu- 
reau  on   the   principal    causes 
of,  36;  and  principal  causes  of 
in  the  U.  S.,  36 

Death-rate,  and  overstrain  of  vi- 
tal organs,  41 ;  caused  by  can- 
cer, doubled  in  forty  years, 
95;  caused  by  various  acci- 
dents, 63 ;  due  to  typhoid 
fever,  in  Chicago,  76;  in  Great 
Britain,  76;  in  the  U.  S.,  76; 
from  disease  in  U.  S.  Army 
during  World  War,  80;  from 
tuberculosis,  103;  in  the  U.  S. 
per  1000  of  population  from 
1907  to  1917  — Table  No.  I, 
377;  increase  of,  from  Bright's 
disease  since  1900,  42;  increase 
of,  from  degenerative  disease, 
61 ;  increase  of  since  1906 
caused  by  diseases  of  heart. 
42 ;  city  and  rural  compared, 
35 ;  effect  of  race  on,  35 ; 
from  "  old-age  "  disorders,  150 ; 
number  due  to  cancer,  92 ; 
statistics  of,  34;  table  of,  for 
white  males,  35;  world's,  24 


INDEX 


Death-rates  at  different  ages  in 
the  registration  area  —  Table 
No.  4,  382 

Deaths,  number  due  to  accidents 
and  violence,  63 

Decadent  classes,  329 

Defective  problem,  the,  in  Ill- 
inois, 338 

Defectives,  and  industrial  acci- 
dents, 309;  and  medical  aid, 
321 ;  and  surgery,  349 ;  border- 
land, 316;  education  of,  348; 
"  functional,"  324 ;  in  institu- 
tions, 330;  marriage  of,  348; 
mental,  in  hospitals,  60;  num- 
ber of  school  children  in  Eng- 
land and  Wales,  6p;  segrega- 
tion of,  348;  sterilization  of, 
349;  why  support?,  355 

Defects,  physical,  in  school  chil- 
dren, 274,  275 ;  physical,  num- 
ber of,  in  Chicago  school  chil- 
dren, 60 

Degenerative  diseases,  denned, 
133 ;  increase  of,  83-84 

Delinquents,  effect  of  religion  on, 
313;  juvenile,  296;  mental  and 
manual  training  for,  313 

Dementia  praecox,  257,  320 

Detention  of  the  irresponsible, 
312 

Detroit  Health  Department,  cited 
on  prostitution,  120 

Devine,  Edward  F.,  quoted  on 
ill  health  in  relation  to  poverty, 

395 

Diabetes,  deaths  due  to,  38 

Diarrhea,  deaths  caused  by,  38 

Diet  list,  for  auto-intoxication, 
special,  404;  for  kidney  dis- 
orders, 169-171 ;  of  laxative 
foods,  405 

Dietetic  errors,  and  degenera- 
tive disorders,  156;  habits,  im- 
proved, 88 

Disease,  prevention  of,  191-192; 
toxins,  173 

Diseases,  contagious  and  lessen- 
ing of  death-rate,  39 

Distribution  of  feeble-minded  — 
Table  No.  10,  388 


Divorce,  and  dysge.nic  traits,  353 

Draft-disability  findings,  signifi- 
cance of,  13 

Draft,  examination,  causes  for 
rejection,  15;  military,  12;  mil- 
itary and  tuberculosis,  104; 
number  of  men  registered  in, 
12 

Drowning,  deaths  caused  by,  38 

Drugs,  consumption  of,  156; 
habitual  use  of,  154 

Dugdale,  cited  on  the  Jukes  fam- 
ily, 334 

Dysgenic  traits  and  divorce,  353 

Ear  trouble,  19 
Eating,  the  art  of,  186 
Economic    loss,    from    sickness, 
392;     through     ill     health     in 
California,  400;  in  North  Caro- 
lina, 398 

Economic  value,  of  increased 
health,  402;  of  postponing 
death,  401 

Education  of  defectives,  348 
Endocarditis,   and   the   gonococ- 

cus  germ,  116 

Enteritis,  deaths  caused  by,  38 
Environment,  and  crime,  282,  312 
Epididymitis,  116 
Epilepsy,  and  heredity,  265;  and 
sex   perversion,  263;   in   New 
York,  265 

Epileptic  problem,  the,  263 
Epileptics,  and  detention,  312 
Erb,  cited  on  syphilis,  123 
Estabrook,  quoted  on  the  Jukes 

family,  355 

Eugenic  examinations,  363;  in- 
vestigations, 89 

Eugenics,    biologic    aspects    of, 
360;  financial  aspects  of,  361; 
humanitarian  side  of,  360;  re- 
strictive,  desirability  of,   358; 
restrictive,  ethics  of,  360 
Evans,  quoted  on  epilepsy,  266 
Examination,  annual  medical,  14 
Examinations,  draft,  causes  for 
rejection,    15;    medical,    value 
of  annual,  43 


INDEX 


415 


Exercise,  and  "old-age"  dis- 
orders, 159,  166;  physical,  184 

Exertion,  and  bad  heart,  41 ; 
and  exercise,  41 

Expectation  of  life,  loss  of,  from 
1890  to  1910,  46 

Eyesight,  defective,  16 

Families,    largest,    among    most 

recent  immigrants,  34 
Fatigue,  and  neurotic  disorders, 

63 

Fatty  degeneration,  137 
Feeble-minded,  and  physical  de- 
f ectiveness,  248 ;  first  attempt 
at  housing  of,  346;  in  institu- 
tions, 331 ;  in  institutions  — 
percentage  reported  as  physi- 
cally defective  — Table  No.  8, 
386 

Feeble-mindedness,  and  crime, 
280,  292;  and  drink,  309;  and 
heredity,  242;  and  physician's 
".  attitude,  248;  and  poverty,  306; 
and  prostitution,  302;  defined, 
233,  286;  in  relation  to  vice 
and  poverty,  299;  in  the  U.  S., 
236;  origin  of,  241;  standards 
of,  239 

"Feebly  inhibited,"  the,  260,  326 
Feet,  remedies  for,  17 ;  troubles 

of,  17 
"  Female   complaint,"   origin   of, 

120 

Female  paupers  enumerated  in 
almshouses  on  January  I,  1910, 
or  admitted  during  1910,  who 
are  reported  to  have  borne 
children,  classified  by  number 
of  children  born,  and  by  race, 
nativity,  and  age  of  mother, 
for  the  United  States  as  a 
whole,  390 

Financial  aspects  of  eugenics,  361 
Fisher,  cited  on  life  extension,  65 
Food,   bad,   and   effect  on   cells, 
138;     increased    amount    con- 
sumed, 42 

Foods,  laxative,  special  diet  list 
of,  405;  tending  to  acidify  the 


blood,    172;   to  alkalinize   the 

blood,  172 

Forsyth,  quoted  on  longevity,  46 
"Fourth   Disease,"   the,   defined, 

^"9. 

Fourmer,  cited  on  syphilis,  123 

"  Functional  defectives,"  324 

Gall  bladder,  and  X-ray,  173 

Glands,  sweat,  148 

Goddard,  cited  on  feeble-minded- 
ness,  244 ;  quoted  on  the  Kalli- 
kak  family,  356 

"  Going  insane,"  224 

Gonococcus  germ,  116 

Gonorrhea,  20,  124;  and  sterility, 
116;  cause  of,  116;  defined, 
116;  treatment  of,  117-118. 

Gonorrheal  arthritis,  116;  infec- 
tion, cause  of  sterility  in 
women,  118;  infection  in  chil- 
dren, 117 

Gould,  quoted  on  backward  chil- 
dren, 272 

Cowers,  cited  on  inheritance  in 
epilepsy,  265 

"  Habit   disorders,"   increase  of, 

83 

Health  and  Old  Age  Insurance 
Commission  of  Ohio,  sickness 
survey  of,  52 

Health  audit,  and  business,  45 ; 
organizations,  modern,  89;  the 
modern,  44 

Health,  "  fads,"  50 ;  laws  of,  in  a 
nutshell,  181 ;  literature,  86 ;  in- 
ventory, national,  12 ;  "  span  " 
of  life,  67-68;  supervision,  an- 
nual, 88 

Healthful  clothing,  185 

Healy,  cited  on  stigmata  of  de- 
generacy, 319;  quoted  on  Binet 
scale,  239;  on  cause  of  crime, 
281,  282;  on  constitutional  in- 
feriority, 257;  on  heredity  and 
crime,  291 ;  on  hyper-sex- 
ualism,  268;  on  masturbation, 
270;  on  sociopathic  individuals, 
301 ;  cited  on  subnormality,  276 


416 


INDEX 


Heart,  affections,  ip;  conpensa- 
tion  of,  146;  disease,  early 
symptoms  of,  144-145;  disease, 
increase  of  death-rate  from, 
since  1900,  42;  disease,  prin- 
cipal cause  of  death  in  the  U. 
S.,  61 ;  defined,  143 ;  disorders, 
number  of  deaths  caused  by, 
37 ;  diseases,  increasing,  142 ; 
failure,  142;  failure  due  to 
.  high  blood-pressure,  147 

Hereditary  disorders,  general, 
325 

Heredity,  and  cancer,  98;  and 
criminals,  60;  and  epilepsy, 
265 ;  and  f  eeble-mindedness, 
242 ;  and  hysteria,  203 ;  and  in- 
efficiency, 50;  and  insanity, 
222;  and  internal  secretions, 
322;  and  longevity,  140;  and 
morality,  127;  and  morons, 
253;  and  old  age,  162;  and 
pauperism,  60 ;  and  psychasthe- 
nia,  200 ;  and  sex  perverts,  267 ; 
and  syphilis,  1 1 1 ;  and  the  Kal- 
likak  family,  356;  and  tuber- 
culosis, 107 ;  criminal,  290 

Hernia,  or  rupture,  18 

Heron,  David,  cited  on  decline  of 
birth-rate  of  the  healthy,  243 

Hickson,  cited  on  the  backward 
child,  272;  quoted  on  the  cause 
of  crime,  253 ;  definition  of 
"  idiot,"  "  imbecile,"  "  moron," 
and  "  sociopath,"  254 

Homicides,  number  of  deaths 
caused  by,  39 

Hookworm  disease  in  the  South, 
62 

Hot  weather,  deaths  caused  by, 
38 

Hough,  cited  on  syphilis,  124 

Howard,  cited  on  malaria,  62; 
in  the  South,  62 

Huntington's  chorea,  317,  326 

Hygiene,  advances  in,  in  quarter 
century,  71 ;  personal,  and 
health  propaganda,  84 ;  race,  8 ; 
teaching  of,  in  public  schools, 
85 


Hygienic  teaching,  improved,  87 
Hyper-sexualism,  and  the  Negro, 

268 

Hypochondriacs,  206 
Hysteria,  202;  hereditary  nature 

of,  203;    symptoms,   204 

Idiots,  and  criminality,  236 

Illegitimate  births,  304 

Illinois  commission,  sickness  sur- 
vey of,  52 

Immigrants,  Americanization  of, 
4;  and  insanity,  227;  as  dis- 
ease carriers,  356-358 

Imbeciles,  236 

Industrial  medical  supervision,  86 

Inebriety,  308 

Infant  welfare,  86 

Infections,  chronic,  160 

Influenza,  and  the  army,  79; 
deaths  caused  by,  38 

Insane,  enumerated  at  each  cen- 
sus from  1850  to  1910  —  Table 
No.  5,  383;  marriage  laws  re- 
lating to  the,  224;  in  institu- 
tions, 331 ;  in  institutions  com- 
pared to  number  of  students  in 
schools  of  the  U.  S.,  63 ;  of  va- 
rious ages  in  the  U.  S.,  1910  — 
Table  No.  6,  383 

Insanities,  non-hereditary,  223 

Insanity,  among  immigrants,  227 ; 
among  Negroes,  229;  and 
heredity,  222;  and  meno- 
pause, 225 ;  conditions  leading 
to  increase  of,  218;  in  dif- 
ferent sections  of  the  U.  S. 
—  Table  No.  7,  385;  in  Great 
Britain,  213;  in  the  U.  S.,  212; 
increasing,  212;  recurrent,  226; 
statistics,  analysis  of,  218; 
statistics  on,  214 

Insanity's  threat,  221 

Institutional  defectives,  330 

Institutions,  criminals  in,  331; 
feeble-minded  in,  331 ;  needed 
for  mental  defectives  and  de- 
linquents, 341 ;  number  of  blind 
in,  3*30;  of  deaf  in,  330;  of  in- 
sane in,  331 ;  paupers  in,  331 


INDEX 


Insurance  companies,  and  aver- 
age length  of  life,  41 ;  and 
syphilis,  115 

Insurance  supervision,  86 

Internal  secretions,  and  heredity, 
322 

lodids,  and  syphilis,  114 

Ishmael,  tribe  of,  335 

Ishmaelites,  racial,  334 

Johnson,  quoted  on  defectives, 
332;  on  inebriety  and  hered- 
ity, 309 

Jorger,  cited  on  the  Zero  family, 

337 

Jukes  family,  the,  334 
Juvenile   delinquents,  296 

Kallikak  family,  the,  356 

Kehoe,  cited  on  increase  of  de- 
generacy, 322 

Kidney,  18;  defined,  148;  dis- 
orders, chronic,  148;  deaths 
.  caused  by,  37 ;  special  diet  list 
'  for,  169-171 

Kidneys,  and  alcohol,  149;  and 
narcotics,  149;  and  tobacco, 
149;  and  water  drinking,  149; 
overworking  the,  149 

Kraeplin,  cited  on  relation  of 
heredity  to  insanity,  265 

"  L.  "  family,  the,  335  . 

Laennec,  cited  on  syphilis,  123 

Langmead,  quoted  on  feeble- 
mindedness, 239 

Lankaster,  Sir  Ray,  quoted  on 
racial  degeneration,  329 

Laughlin,  cited  on  defectives  in 
the  U.  S.,  333 

Law,  sterilization,  of  Indiana,  349 

Laws,  marriage,  relating  to  the 
insane,  224 ;  of  health  in  a  nut- 
shell, 181 

Life,  average  length  of,  34,  39; 
Expectancy  Tables  —  Table 
No.  3,  379-381 ;  "  health  span  " 
of,  67-68 ;  insurance  companies 
and  cancer,  98 

Liver,  cancer  of,  38 


Lombroso,  cited  on  relation  be- 
tween genius  and  insanity,  263 

Longevity,  and  heredity,  140;  in 
the  U.  S.,  45 ;  of  foreign-born 
whites,  46;  of  native  Amer- 
icans, 46 

Loss  of  working  time  and  wages, 
393 

Lung,  cells  and  impure  air,  138; 
trouble,  19 

Malaria,  62 

Marriage,  and  the  backward 
child,  277;  and  syphilis,  n$; 
laws  relating  to  the  insane, 
224;  of  defectives  and  degen- 
erates, legislation  against,  348; 
rates,  decline  of  in  civilized 
countries,  32;  restrictive,  352; 
restrictions  on  age,  354 

Massage  and  skin  friction,  and 
"  old-age  "  disorders,  166 

Maternal  impressions,  317 

Masturbation,  269 

McDougall,  quoted  on  cause  of 
crime,  281 

Meat-eating,  and  effect  on  blood- 
pressure,  157 ;  and  "  old-age  " 
disorders^  157;  effect  on  kid- 
ney, liver,  and  heart,  158 

Medical,  examination,  annual,  14, 
43 ;  inspection  of  school  neces- 
sary, 61 

Medicine,  advances  in,  for  mili- 
tary use,  79;  and  mental  de- 
fectives, 321;  preventive,  14; 
preventive,  and  all  phases  of 
public  health  improvement,  74; 
preventive,  triumphs  and  fail- 
ures of,  71 

Medicines,  patent,  increased 
amount  consumed,  42 

Melting-pot,  delusion  of,  9 

Mental  and  manual  training,  313; 
attitude  and  blood-pressure, 
160;  defectives  in  hospitals,  60; 
diseases,  20;  diseases  and  high 
blood-pressure,  147 ;  subnor- 
mality  and  backwardness,  276 

Menopause,  and  insanity,  225 

'Mercury,  and  syphilis,  114 


INDEX 


Metabolic  poisons,  and  cells,  138 

Metropolitan  Life  Insurance 
Company,  sickness  surveys  of, 
51,  S2,  53J  statistics  on  sick- 
ness and  wage-earner,  397 ;  un- 
employment survey,  52,  53 

Microbe,  and  microscope,  74; 
mastering  the,  75 

Microscope,  and  microbe,  74 ;  and 
sanitation,  73 

Migraine,  208 

Milk,  and  fruit-juice  regime,  407 ; 
diet,  and  blood-pressure,  173 ; 
tuberculosis  contracted  from, 
105 

Miners,  number  of,  killed,  and 
injured  by  accidents,  63 

Mitral  regurgitation,  145;  steno- 
sis and  women,  145 

Morality  and  heredity,  127 

Moron,  the,  236 ;  colony  proposed, 
259 ;  "  middle-grade,"  and  back- 
wardness, 300;  problem,  the, 
253 ;  statistics,  255 

Moronism,  and  heredity,  253 ;  de- 
fined, 254 

Morphine,  effect  on  blood-pres- 
sure, 177 

Morrow,  quoted  on  venereal  dis- 
ease, 124 

Murders,  committed,  annual,  63 

Muscles,  weakened,  41,  42 

Nam  family,  334 

Narcotics,  and  feeble-minded- 
ness,  309;  effect  of,  on  cells, 
139;  on  kidneys,  149 

Natural  selection,  77,  333 

Negro,  and  disease,  35 ;  and 
hyper-sexualism,  268;  and  in- 
sanity, 229;  mortality  among 
children,  35;  teeth  of,  27 

Nephritis,  148,  150 

Nervous  diseases,  20;  causes  of, 
64;  hypertension,  175 

Nervousness,  general,  195 

Neurasthenia,  earmarks  of,  198; 
symptoms  of,  197 

Neurasthenics,  196 

North  Carolina,  sickness  survey 
of,  55 


Number  of  insane  in  institutions 
compared  to  students  in  schools 
of  the  U.  S.,  63 

Ohio,  sickness  survey  in,  52 

Old  age,  defined,  139 

"  Uld-age "  diseases,  and  condi- 
ments, 156;  increase  of,  83,  132, 
140;  and  exercise,  159,  166; 
and  deficient  elimination,  159; 
and  heredity,  162;  and  meat- 
eating,  157;  and  proteins,  156; 
causes  of,  154;  remedies  for, 
165 ;  treatment  of,  165 

Ophthalmia  neonatorum,  116 

Osier,  Sir  William,  cited  on  pros- 
titution in  Cologne,  120 

Overeating,  and  Americanitis,  157 

Overweight,   17 

Owen  family,  the,  335 

Paralysis,  number  of  deaths 
caused  by,  38 

Patent  medicines,  increased  use 
of,  42 

Patriotism,  highest,  369 

Paupers  enumerated  in  alms- 
houses  on  January  i,  1910, 
classified  by  race,  nativity, 
parentage,  sex,  and  age  at  enu- 
meration, for  the  United 
States  as  a  whole  —  Table  No. 
ii,  389 

Paupers,   in   institutions,  331 

Pennsylvania  Health  Insurance 
Commission  surveys,  51 

Personal  liberty  doctrine,  the, 
and  sterilization,  351 

Plague,  great  black,  the,  no; 
white,  the,  102 

Plagues,  epidemic,  77,  78;  not  yet 
conquered,  78 

Philadelphia  sickness  survey,  52' 

Physical  conditions,  abnormal, 
leading  causes  of,  318;  exer- 
cise, 184;  side  of  crime,  293 

Physically  defective  feeble- 
minded, 248 

Piles,  or  hemorrhoids,  18 

Pinkus,  cited  on  venereal  dis- 
orders, 123 


INDEX 


419 


Pittsburgh  sickness  survey,  57; 
economic  loss  from  sickness  in, 
399 

Pneumonia,  deaths  due  to,  37 

Podstata,  cited  on  insanity,  213 

Poellmann,  quoted  on  defective 
family,  338 

Poisons,  cell,  138;  metabolic,  138 

Poisoning,  ptomaine,  138 

Pollack,  cited  on  gonorrheal  in- 
fection in  children,  117 

Population  of  cities,  increase  of, 
in  fifty  years,  42 

Poverty,  and  feeble-mindedness, 
306 

Prevention  of  disease,  191-192 

Prison   reform,   312 

Problem  of  defectives  in  Illinois, 
338;  of  delinquent  and  criminal 
classes,  311;  sickness,  the,  51 

Problems,  economic,  2;  indus- 
trial, 2 ;  moral,  in  relation  to 
heredity,  5,  6;  nation's  health, 
«7;  political,  in  relation  to  phys- 
ical status  of  people,  3;  race, 
i ;  social,  4 

Prostatic  trouble,  120 

Prostitution,  120;  and  feeble- 
mindedness, 302;  and  findings 
of  Chicago  Morals  Court,  253 

Prostitutes,  number  of  in  U.  S., 
121 

Proteins,  and  "  old-age "  dis- 
orders, 156,  158 

Psychasthenia,  200;  symptoms  of, 
201 

Psychopathic  Laboratory,  direc- 
tor of,  quoted  on  delinquency, 
319 

Ptomaine  poisoning,  138 

Pulse  pressure,  normal,  174 

Punishment,  and  crime,  312 

Pusey,  cited  on  syphilis,  123 

Pyorrhea,  27 

Race,  and  American  citizenship, 
8;  and  crime,  285 ;  effect  of,  on 
death-rate,  35;  hygiene,  8 

Racial  instability,  205 ;  Ishmael- 
ites,  334 

Radium,  and  cancer,  98,  99 


Railroad  accidents,  number  of 
deaths  caused  by,  63 

Religion,  and  delinquents,  313 

"  Rest  Cure  "  diet,  407 

Rest,  relaxation,  and  recreation, 
189-191 

Restrictive  eugenics,  desirability 
ot\  358 ;  ethics  of,  360 ;  legis- 
lation regarding  marriage  of 
defectives  and  degenerates, 
348;  marriage,  352;  program 
for  unfit,  344 

Restricting  the  unfit,  344 

Rheumatism,  19 

Richards,  cited  on  backwardness 
in  children,  273 

Rittenhouse,  cited  on  degenera- 
tive diseases,  132 

Rochester  sickness  survey,  the, 
53 

Rosanoff,  cited  on  mental  defi- 
ciency, 339 

Rupture,  or  hernia,  18 

Sajous,  quoted  on  dementia  prae- 
cox,  320;  on  "  functional  defec- 
tives," 324;  on  heredity,  322- 
324;  on  mental  defectives,  322 

Salpingitis,    116 

"  Salt  habit,"  effect  on  heart,  kid- 
neys, and  liver,  157 

Sanitation,  ancient,  71 ;  and  the 
miscroscope,  73 

School  children,  number  of  de- 
fective in  Chicago,  60 ;  in  Eng- 
land and  Wales,  60;  in  New 
York,  60 

School  inspection,  87 

Science,  and  the  prolongation  of 
life  of  the  mentally  and  phys- 
ically inferior,  78;  and  the  un- 
fit, 39 ,'  dawn  of  modern  sanita- 
ry f  73  >  of  sanitation,  oldest 
known  in  America,  73 

Segregation  of  defectives,  348 

Seguin,  founded  school  for  idiots 
in  Paris,  347 

Septicemia,  116 

Sex  perverts,  266,   267 

Sexualism,  abnormal,  268 

Sick-headache,  nervous,  208 


420 


INDEX 


Sickness,  and  business  failure, 
50;  and  domestic  friction,  50; 
and  economic  distress,  395 ; 
cause  of  destitution  in  San 
Francisco  and  Los  Angeles, 
396;  economic  loss  from,  in 
North  Carolina,  398;  in  Pitts- 
burgh, 399;  economic  losses 
from,  392;  in  the  U.  S.,  pre- 
ventable, 49 ;  responsibility  for, 
392;  statistics  in  Boston,  397; 
survey,  51 ;  survey  in  Connecti- 
cut, 52;  in  Ohio,  52;  in  Ohio 
cities  and  economic  loss  from, 
400;  of  Boston,  56;  of  North 
Carolina,  55;  of  Philadelphia, 
52 ;  of  Pittsburgh,  57 ;  of  Roch- 
ester, 53;  of  the  Illinois  com- 
mission, 52 ;  of  the  Metropoli- 
tan Life  Insurance  Company, 

.51,  52 

Simon,  quoted  on  idiot,  imbecile, 
and  feeble-minded,  240 

Simple  living,  87 

"606,"  and  syphilis,  114 

Skin,  and  kidneys,  148 

Sleep  and  rest,  effect  on  blood- 
pressure,  167 

Soft  chancre,  defined,  119 

Sores,  and  cancer,  96,  98 

Spasms,  habit,  and  tics,  207 

Spirochaeta  pallida,  in 

Stammering,  and  stuttering,  208 

Standard  of  vital  endurance,  40 

Statistics,  Boston  sickness,  397; 
moron,  255 ;  on  insanity,  214 ; 
venereal  disease,  122 

Stature,  23 ;  England's  military, 
lowered,  23 ;  French,  short  of, 

23 
Stenosis,  mitral,  among  women, 

145 
Sterility,  and  gonorrhea,  116;  in 

women,  caused  by  gonorrheal 

infection,  118 
Sterilization,  law  of  Indiana,  349; 

laws,  358;  objections  to,  350; 

of  defectives,  349;  process  of, 

known  to  ancients,  73 
Stigmata     of     degeneracy,     and 

criminals,  319 


Stokes,    cited   on    syphilis,    in; 

on  syphilitics,  121 
Stomach,  cancer  of,  38 

Toxins,  disease,  173 ;  syphilitic, 
139 

Tredgold,  cited  on  decline  of 
death-rate,  61 ;  on  mental  un- 
soundness,  243 

Treatment,  of  gonorrhea,  117- 
118;  of  syphilis,  114 

Tribe  of  Ishmael,  335 

Tubercle  bacilla,  and  milk,   105 

Tuberculosis,  among  children, 
104;  and  heredity,  107,  bo- 
vine, 105 ;  causes  of,  103 ; 
death-rate,  103 ;  deaths  caused 
by,  37;  defined,  102;  germs, 
and  sunlight,  182;  not  in- 
herited, 102;  number  con- 
stantly ill  from,  62;  sugges- 
tions to  prevent,  106;  symp- 
toms of,  103. 

Tumors,  number  of  deaths 
caused  by,  38 

Typhoid  fever,  and  the  Ameri- 
can farmer,  77;  annual  num- 
ber of  deaths  caused  by,  62; 
annual  number  of  cases,  62 ; 
being  eradicated,  76;  deaths 
caused  by,  in  Chicago,  76;  in 
Great  Britain,  76;  in  the  U.  S., 
76 

Typhus  fever,  and  the  army, 
79 

Underweight,  causes  of,  17 
Unemployment  survey  of  Metro- 
politan   Life   Insurance   Com- 
pany, and  sickness  or  accident 
disability,  53 

Unfit,    restriction  of,  344 
Urethra,  stricture  of,  and  gonor- 
rhea, 116 

Urinary   troubles,    18 
Urine,    149 

Varicocele,    18 
Vasectomy,   349 

Vedder,  cited  on  prostitution, 
120;  on  syphilis,  123,  124 


INDEX 


421 


Veins,  varicose,  18 

Venereal  disease,  among  troops 
in  Philippines,  122;  statistics, 
122 

Venereal  diseases,  119;  and  ar- 
terial degeneration,  156;  and 
the  U.  S.  Army,  121 

Vice  and  poverty,  and  feeble- 
mindedness, 299 

Wage-earners,  average  annual 
number  of  disability  days  of, 
58 

Wallin,  cited  on  feeble-minded- 
ness,  209 ;  on  persecution  of  the 
f eeble-minded,,  346 ;  points  on 
distinction  between  defective- 
ness  and  backwardness,  301 

Wassermann  test,  113,  115 


Water,  and  constipation,  406; 
contaminated,  effect  on  cells, 
138;  drinking,  188;  drinking, 
effect  on  kidneys,  149 

Water  supply,  of  Athens,  73 ;  of 
Egyptians,  72;  of  Jerusalem, 
72;  of  Rome,  73 

White  plague,  the,  102 

Williams,  quoted  on  syphilis, 
124 

Woodward,  cited  on  bovine  tu- 
berculosis, 105 

Wood,  Thomas  D.,  quoted  on 
defective  school  children,  275 

X-ray,  and  cancer,  98,  99;  and 
gall  bladder,  173 ;  and  teeth,  1 6, 
173 

Zero  family,  the,  335 


A    000  651  005     1 


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